top of page

NRT   ACT Graduate 

®

Clinical Mastery Enhancement
Program

Early Consideration Form

Thank you for your interest in the upcoming NRT ACT Graduate Clinical Mastery Enhancement Program.

This intensive three-module program is being designed exclusively for experienced ACT Graduates who are committed to expanding their clinical skills, improving patient results, and building even stronger referral-based practices.

Submission of this Early Consideration Form does not obligate you in any way. It simply allows me to better understand your background, your current practice, and the areas in which you would most like additional training. Your responses will also help me tailor this program to best meet the needs of those who attend.

Please take a few minutes to complete the information below.

Contact Information
Your NRT Background
Approximately when did you complete ACT?
Before 2010
2010–2015
2016–2019
2020–2025 (Zoom Era)
ACT Training Completed
Full Program (ACT =Advanced Clinical Training / RTCM = Route to Clinical Mastery)
ACT Part One (Modules 1–4) or Professional Level Only
Your Practice Today
Approximately how many standard NRT office visits do you conduct each week?
Under 25
25–50
51–75
76–100
Over 100
Do you currently have associates in your practice?
No
One
Two or More
Are you planning to add associates within the next two years?
Yes
No
Possibly
What Interests You Most?
Please check all that apply.
Your Biggest Challenge
If You Could Spend Three Days With Dr. Freddie...
Additional Comments
One Final Question
If this program is designed to meet your needs and expectations, which best describes your current level of interest?
I would definitely attend if accepted.
I would probably attend.
I need more information before deciding.
bottom of page