Healthy Living Profile Submission Form

With a photo and 200 words we’ll capture the essence of your business so readers can learn who you are and what you have to offer. Contact information at the top will make it easy for our readers to find you and the ad reference at the end will ensure they don’t miss your ad. Not a writer? No problem. Just answer the short questionnaire and we’ll take care of the writing. You’ll have a chance to edit and approve anything we write. Keep in mind the 200 word limit when filling out the form so editors will have a better idea of what information you believe is most important for our readers. 

To view samples CLICK HERE.

Fields marked with an asterisk* are required.

Profile Pricing: * Non-advertiser - $275
Current advertiser - $250
Full Name: *
Company Name: *
Phone number (For writer to contact you): *
E-mail Address (For writer to contact you): *
Phone number (For readers to contact you): *
E-mail Address (For readers to contact you): 
Company Address: *
Website URL: *
When and where was your business founded?: *
What is your educational background?: *
(List degrees and any other special training/certifications) 
Please define your medical/dental practice, wellness/healing center or healthy living/green business: *
(Include as many facts and info as you'd like such as specialties, modalities offered, unique features, etc.)
Wellness/Healthy Living/Green services offered: *
Areas of specialty:*
Philosophy of healing/healthy/green living:*
Other information: (250 word maximum)   
Comments:  
After submitting, you will be contacted with payment instructions. Credit Card only.

You may upload an attachment with your submission. We accept the following file types:
jpg,jpeg,pdf,tiff,eps


File: