HEALTH PRACTITIONER PORTAL

HP Info Form

HP Referral Form

Health Practitioner Referral Form

In order to refer a client to a LHN Health Practitioner. Please fill out the following details and we will start the process of getting the appropriate contracts set up and sent to you both. Thank you for trusting in our service.

If you would like to refer a client and have a question or need help deciding which practitioner to choose, please email us at lateralhealthnetwork@gmail.com

Step 1) Enter Your Information Here:

First Name

Last Name

Phone Number

Step 2) Enter Referred Health Practitioner Information Here:

Referred Health Practitioner is the practitioner that will be conducting the service.

First Name

Last Name

Phone Number

Service You Offer

Step 3) Clients Name

The client that is being provided the service.

First Name

Last Name

Thanks for submitting! Your contract will be in your email shortly.

HEALTH PRACTITIONER PORTAL

Become an lhn health practitioner

invite a health practitioner

refer a client to an lhn health practitioner

Health Practitioner Information Form

Thank you for your interest in working with us! We have an exciting new team that is growing everyday and would love to hear more about you! Please fill out the following form so that we can get to know a little about you and review your application.

Health Practitioner Referral Form

In order to refer a client to a LHN Health Practitioner. Please fill out the following details and we will start the process of getting the appropriate contracts set up and sent to you both. Thank you for trusting in our service.

If you would like to refer a client and have a question or need help deciding which practitioner to choose, please email us at lateralhealthnetwork@gmail.com

Step 1) Enter Your Information Here:

Step 2) Enter Referred Health Practitioner Information Here:

Referred Health Practitioner is the practitioner that will be conducting the service.

Step 3) Clients Name

The client that is being provided the service.

HEALTH PRACTITIONER PORTAL

Become an lhn health practitioner

invite a health practitioner

refer a client to an lhn health practitioner

Health Practitioner Information Form

Thank you for your interest in working with us! We have an exciting new team that is growing everyday and would love to hear more about you! Please fill out the following form so that we can get to know a little about you and review your application.

Health Practitioner Referral Form

In order to refer a client to a LHN Health Practitioner. Please fill out the following details and we will start the process of getting the appropriate contracts set up and sent to you both. Thank you for trusting in our service.

​

If you would like to refer a client and have a question or need help deciding which practitioner to choose, please email us at lateralhealthnetwork@gmail.com

Step 1) Enter Your Information Here:

Step 2) Enter Referred Health Practitioner Information Here:

Referred Health Practitioner is the practitioner that will be conducting the service.

Step 3) Clients Name

The client that is being provided the service.