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Herbaland's RD Collaborative Sign Up
Thank you for your interest in Herbaland's Registered Dietitian Collaborative program! We are very excited to get to know you!
Please fill out the following application form to sign up for our program:
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Name
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Your answer
Email
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Your answer
Street Address
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Your answer
City
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Your answer
Zip Code/Postal Code
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Your answer
State/Province
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Your answer
Country
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Choose
USA
Canada
What is your area of expertise? Select all that apply:
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General wellness/prevention
Sports nutrition
Renal nutrition
Women’s health
Bariatrics
Gastrointestinal health
Integrative and functional medicine
Cardiology
Oncology
Pediatrics
Other:
Required
Which sector best describes your career in dietetics?
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Clinical/hospital
Private practice
Nutrition communications
Media
Research
Retail/supermarket
School foodservice
Foodservice
Corporate nutrition
Gym/fitness studio
Virtual nutrition counselor
Other:
Required
What media channels are you currently using to support your clients?
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Instagram
Facebook
Twitter
Pinterest
LinkedIn
Blog
Newsletter/Email
Physical flyers or handouts
Other:
Required
What types of materials/resources are you currently using to support your clients?
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Nutrition related articles/blogs
Social/digital content
Coupons/discount codes
Educational handouts
Product samples
Recipes
Other:
Required
Instagram handle
Your answer
Tiktok handle
Your answer
Facebook handle
Your answer
Do you have any food allergies?
*
Your answer
Do you contribute to media outlets?
*
Yes
No
If you do contribute to media outlets, can you specify which outlets?
Your answer
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