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FAQ

Contact

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Just complete the form below and click the SUBMIT button. We will send materials as soon as there is a program that matches your counseling conversations with patients or clients.

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PulseConnect Registration Form

Register with PulseConnect

First Name*

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Last Name*

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Email*

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Phone Number

Company*

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Professional Title

Address Type*

Home Office PO School

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Street Address*

Apt / Suite / Unit

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ZIP*

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Please input your license titles:*

CDCES CMA CNM DO DTR LDN LPN MD MPH ND MS NP PA PhD PharmD RD/RDN/LDN/CDN RN/APRN RPh OTHER

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What best describes your primary specialty?*

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What best describes your secondary specialty?

Which best describes your primary work setting?

Please describe your work setting*

Please describe your work setting.

How many people do you counsel, coach or advise per week?

On which of the following topics do you regularly counsel patients or clients?

Allergies Digestive Health Diabetes Fitness and Exercise Immune Health Nutritional Supplements Senior Health Women's Health Heart Health Pediatrics Weight Management/Obesity Aging Children's Health & Nutrition General Nutrition Pregnancy/Childbirth Men's Health None of the above

Which of the following do you use for your professional work and/or to share health and wellness information?

Blog Facebook Instagram LinkedIn Local Newspaper Local TV TikTok X / Twitter None of the above

What percentage of your patients or clients are Spanish-only speakers/readers?

What percentage of your patients or clients qualify for/are on WIC?

How do you see patients?

Both in person & virtually In person Virtually

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