Practitioner & Coach Listing Registration & Renewal Update

If you are a Certified GAPS Coach or Practitioner, we are happy to list your business at GAPS Diet Australia for our Australian GAPS community to locate and contact you. Please complete the below form and submit your registration to list your business or to renew/update your details.

*IMPORTANT: It is the responsibility of the practitioner or coach to advise of any changes to your listing by re-submitting.

This form is to be completed by “Trained & Certified GAPS Practitioners & Coaches” ONLY If you are not certified, your registration will not be authorised and your details will not be listed.

YOUR GAPS CLINIC BUSINESS PROFILE

Your profile details below will be added to the Practitioner or Coach Listing when you are ready to practice. Please indicte your status below.
Practitioner Registration Status *

Practitioner Registration Status I have completed the GAPS training and wish to add my listing on the GAPS Australia site I am already listed on the site and I wish to update my details Other Other
Training Certification

Please advise on your GAPS Training Certification below
Practitioner Registration Status *

Practitioner Registration Status PRACTITIONER: I have completed the Certified GAPS Practitioner Training Course with Dr Natasha Campbell-McBride COACH: I have completed the Certified GAPS Coach Training Course with Dr Natasha Campbell-McBride Other Other
Please upload your Certified GAPS Training Certificate *

Attach Files
Date GAPS Training Course Completed Date GAPS Training Course Completed * / DD / MM YYYY

IMPORTANT Remember to renew your registration each year on this date to remain on the Practitioner Listing
Name Name * First Last
Practice/Business Name *
Your Current Business Address Your Current Business Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Business Phone Number: *

(area code) + number
LEAVE NO SPACES BETWEEN NUMBERS & NO BRACKETS
Business Email *
Web Site
OLD ADDRESS: If you are updating your renewal with a new address above, please complete your old address below so that we can find you in our Listing by state and delete your old content. If this is not supplied, your new address can not be added. (otherwise please ignore this step) OLD ADDRESS: If you are updating your renewal with a new address above, please complete your old address below so that we can find you in our Listing by state and delete your old content. If this is not supplied, your new address can not be added. (otherwise please ignore this step)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
PROFESSIONAL

Your professional qualifications and area of special interest
Professional Qualifications: *

ie: Naturopath, Nutritionist, Nutrition Consultant
Areas of Special Interest *

ie: Specialising in women's health, autism, heart health, autoimmune disorders or
Simply state if you do not have a specialty
Your listing update may take up to 2 months before it is activated because we only update our listings by monthly as a free form of advertising service to GAPS Professionals. Please feel free to contact us again if you do not see your listing activated after this time and we will follow up for you.

Don't forget to join in on the conversations and reach out to people in the Australian GAPS community at the Official GAPS Australia Support Group on Facebook: https://www.facebook.com/groups/128653767814470
Other comments

Practitioner & Coach Listing Registration & Renewal Update

Practitioner & Coach Listing Registration & Renewal Update

YOUR GAPS CLINIC BUSINESS PROFILE

Training Certification

PROFESSIONAL