Kresser Institute

2018 Eligibility Form

Please note: We changed our eligibility criteria in January 2017. If you filled out the form prior to 2017 and did not qualify or never filled it out thinking you would not qualify, please don’t hesitate to fill it out now. We refined the questions and parameters to evaluate a broader set of criteria beyond just the typical licensing. We now accept a broader array of allied professionals into the course—although seats are still limited so you’ll want to enroll early.

First Name:
Last Name:
Email Address
Active license as a medical professional in your state:
License #
U.S. or International?
U.S. International
Inactive medical license: MD, DO, ND, LAc, DC, RN, RD, NP, PA, DDS
Yes No
Enrolled in educational program that will confer medical license: MD, DO, ND, LAc, DC, RN, RD, NP, PA, DDS
Yes No
Professional certification in nutrition studies (from ITN, IIN, NTA, Bauman College, or similar)
Yes No
Work under direct supervision of licensed medical provider (signature of supervisor required)
Yes No
Work in collaborative clinical setting with licensed providers
Yes No
Graduate-level coursework in medical sciences (anatomy, physiology, pathophysiology, etc.)
Yes No
Currently active private practice with business license, website, and revenue
Yes No
Undergraduate-level coursework in life/medical sciences (biology, chemistry, biochemistry, etc.)
Yes No