Please note that a FES practitioner discount is only valid in the USA, Canada or other countries where there is no FES distributor. Also, please note: Healing Herbs essences can only be shipped within North America.
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
General Description of Practice
Please identify your health or counseling practice(s) (chiropractor, psychiatrist, counselor, homeopath, massage practitioner, etc.)
What are your areas of specialization?
Please comment further on the nature of your practice:
Select a Choice
Do you work alone or with other practitioners?
Work with other practitioners
Do you offer consultations at a distance? Check all that apply.
Only in person
Describe your educational background and special training related to the health field:
What professional licenses and/or degrees do you hold?
Use of Flower Essences
In what year did you begin your practice?
In what year did you begin using flower essences?
What ranges of flower essences do you use? Check all that apply.
Flower essences of Dr. Bach
Other lines of essences used:
Are you actively working with FES research essences? If so, which ones?
Please provide a brief description of noteworthy FES research essences used, why they were used, and to what effects. Any feedback you provide contributes to the research database and helps us to substantiate the use of these particular essences.
How are essences used in your practice? Are they your primary tools in your practice, or are they mainly used to support other types of therapies?
Use to support other therapies
What methods do you use to administer the essences? (dosage bottle, topical application, etc.)
How do you select essences?
Body Therapy Products
Are you working with Self-Heal Creme and/or FloraFusions and TerrAnoint oils? Please describe how they are used in your practice:
Follow-up and Research
Describe your record-keeping procedures:
Do you do follow-up visits or calls with your clients to check their progress?
Are you willing to share case histories for research and educational purposes?
Are you willing to be interviewed on your use of flower essences?
Please tell us about any educational, research or other special projects you may be working on that involve flower essences.
Do you offer classes or other educational services?
If so, please describe your educational programs.
Do you dispense flower essences in dosage bottles?
Do you sell flower essences and other health products to your clients, and/or to the general public?
Please tell us anything additional about yourself and your practice which you think would be important for us to know. We are especially interested in hearing your insights about any particular FES/Healing Herbs flower essences and other FES products that you are using.
Practitioner Referral Network
This is a service of the Flower Essence Society and requires
membership in the Society
Do you wish to be part of the Flower Essence Society Practitioner Referral Network? (You must also be a member of the Society in order to be listed; see link above.)
If you do not wish to be part of the referral network, you needn't fill out the rest of this form.
Not at this time
If yes, please indicate if you wish us to either delete your street address from the online listing, or not include you in the online listing (in which case only our office will give out your information). Check all that apply.
Omit my address in the online listing
Omit my email address in the online listing
Do not list me online
Please describe your fee rates and basis (e.g. flat fee or sliding scale).
Do you bill insurance?
When are you available for consultations?
What is the best phone number to reach you?
We NEVER sell or trade any of our customers' personal information with any other organization or company; and mailings are limited to special sales that would be of interest to you.
Do Not Fill This Out