Root Cause Practitioner Mentorship Program Application

with Sinclair Kennally, Michael Spandel, and Dr. Christine Schaffner

This is a mentorship program designed for practitioners ready to challenge norms, explore new paradigms, and address the root causes behind today's complex health challenges.

Personal Information

Full Name *

Credentials/Certifications *

Practice Name: *

Email Address *

Phone Number *

Location *

City *

State *

Country *

Website *

Time Zone *

Professional Background

Credentials/Professional License *

Years in Practice *

Current Practice Type *

Current Practice Focus *

Modalities Currently Used *

Please briefly describe your practice approach *

What certifications and training have you completed that are relevant to functional/root cause medicine? *

Please describe your most valuable training experience and how it has influenced your practice *

Experience & Motivation

What challenges are you currently facing with your client/patient outcomes? *

Please describe your most significant challenge in more detail *

Why are you interested in the Root Cause Practitioner Mentorship Program specifically? *

Why are you interested in this mentorship? *

Which root causes and health factors do you currently address in your practice? *

Which root causes and health factors do you feel LEAST confident addressing? *

Which root causes would you like to improve your clinical skills, and why? *

Describe a complex case you've worked with where you felt your current protocols or knowledge were insufficient *

How open are you to challenging conventional paradigms, even those accepted in functional medicine? *

Please share an example of when you've challenged a conventional approach in your practice *

Professional Development Goals

What specific areas of root cause medicine are you most interested in developing further? *

What therapeutic tools are you currently utilizing or interested in learning more about? *

How do you envision implementing the knowledge and tools from this program into your practice? *

Please elaborate on your implementation vision *

Personal Attributes

On a scale of 1-10, rate your willingness to:

Unlearn previously accepted protocols that no longer achieve results *

Implement new approaches with clients and patients *

Collaborate with and learn from peers *

Take responsibility for your own results *

Look at challenging topics with optimism *

What personal qualities make you a good fit for this collaborative, pioneering mentorship program? *

Please elaborate on your top 3 qualities that would contribute to the program *

How did you hear about the Root Cause Practitioner Mentorship Program? *

Have you participated in previous programs or courses with Sinclair Kennally, Detox Nation, or Dr. Christine Schaffner? *

If yes, please list which ones

Are you comfortable discussing and implementing protocols that may be considered outside conventional or standard functional medicine? *

Is there anything else you would like us to know about you or your practice? *

Acknowledgments

By submitting this application, I acknowledge that:

I am a certified practitioner actively serving patients/clients, not a student
I understand this program does not offer CEUs at this time
I have a solid working knowledge of health, anatomy, and physiology
I understand this is a mentorship focused on innovative approaches rather than traditional protocols
I take full responsibility for my results in this program and with my clients and patients
If practicing outside the US, I understand I am responsible for sourcing local vendors and supplies
I am committed to participating fully in this intimate, cocreative mentorship experience

Signature *

Clear

Date *

Thank you for your interest in the Root Cause Practitioner Mentorship Program. We will review your application and be in touch regarding next steps. If you have any questions, please contact us at [email protected]