BW3 Register

Be Well Work Well - Register Here!

Community Health Partner Registration Form for Businesses, Nonprofits & Organizations

Welcome aboard, Wellness Partner!

We look forward to growing a wonderful wellness relationship with your organization and team!

Please fill out and submit the form below.

We look for to sending you some "free first-acupuncture-treatment" gift certificates and special flyers to your contact person.

Please address any questions or needs to Robert at robert@communityacu.org. His cell is 970-689-7281.

(Please note that BW3 is intended for businesses or organizations with four or more employees.)

Thank you!

Register for your BW3 Membership Here!

* Indicates required field

Name of Organization *

Name *

First

Last

Email *

Position within organization *

Phone Number *

website address *

Designated contact person with whom we will coordinate as well as send updates and free treatment certificates *

contact's phone number if different from above *

Mailing address *

number of employees *

Submit

Be Well Work Well - Register Here!​

Register for your BW3 Membership Here!

Be Well Work Well - Register Here!