The Hybrid Program Application

Application

The Hybrid Program

A 12-month, life-changing journey designed to help you transform your health, vitality, and purpose. This unique experience combines in-person clinical testing with online coaching, frequency medicine and custom Traditional Chinese Medicine remedies.

Apply Here

We are currently pulling together the details of our next cohort, and will be reaching out as we have more information. Your application is an important part of this process as we’ll be reviewing it and shaping the program around these applications as best we can. We’ll follow up to let you know if we think we’ll be a mutual fit.

First Name

Last Name

Phone

Address (please include city and province)

Current Age

Do you have any diagnosed conditions (or even suspected diagnosis)?

What are the most challenging aspects of your life currently (health, relationships, career, etc.)?

Are you willing to make changes wherever needed in your life (even big ones?)

What other treatments and modalities have you tried already?

Do you have a healthy support network (friends, family, practitioners, etc.)?

Do you have any reservations about following through with a year long program (are you willing to take responsibility and put in the work)?

What are your greatest fears currently?

What would treatment success look like for you after this program?

How would you feel about your diagnosed or undiagnosed conditions resolving completely?

How would you rate your hope for healing on a scale of 1-10?

How would you rate your faith/confidence in your body on a scale of 1-10?

Please make sure this box is checked to signal you agree with the following.

TERMS & CONDITIONS

To get the most out of this course you commit to attending each weekly call, or watching the replay within 2 weeks time of recording. It’s important to flow with the group to make progress and get the results you are looking for.

The MEDISEND and meridian protocol packs are powerful and subtle at the same time and can take time to recalibrate and transform the cellular nature and functional capacity of the body. It’s not generally measured by day to day, but more week to week and overall in the 12 week process of cellular turnover, a lot can shift step by step.

Please be all-in for yourself, you get what you put in.

PRIVACY POLICY: Individual patient confidentiality is an absolute must. This is a safe place and everything discussed as well as names, personal information, personal challenges, health history, and breakthroughs are all confidential. We can build an incredible healing process if it’s held properly. By signing up for this course YOU agree to uphold care, kindness, compassion, openness, personal as well as group safety and complete confidentiality. You are welcome to share about your personal experiences, but you are NOT permitted to speak about others information or participation beyond the group unless given written express permission by all involved.

NEED HELP? If you experience any technical difficulties with this form, please reach out to Lora Groves, our web person, at lora@hummingbirdmedia.ca and she’d be happy to assist you.