Evaluation Request

Evaluation Request to Become a Metamedicine Consultant

This form is designed to accompany you in the important step of requesting your evaluation as a Metamedicine Consultant.

We invite you to fill it out carefully, indicating the seminars you have completed in your journey, the year of attendance, which Facilitators led them, and how many times you participated as an Assistant.

First and Last Name *

email address *

Phone *

SEMINARS ATTENDED *

YEAR *

The first 7 fields in the list are mandatory. If you have repeated some seminars, you can add them to your list with the corresponding year of attendance

No. of EML Assistances *

How many times have you participated in an Emotional Memory Liberation Seminar as an Assistant?

No. of Meta 1 Assistances *

How many times have you participated in a Metamedicine 1 Seminar as an Assistant?

No. LME as observer *

Have you participated in any Emotional Memory Liberation Seminar as an observer? If so, how many times?

Other Information to Report

If you have any other information to communicate, feel free to write it in this space.

SELF-DECLARATION

This declaration, made by the undersigned under their own responsibility, is valid as self-certification pursuant to Articles 46 and 47 of Presidential Decree No. 445 of 28 December 2000.

The examiner reserves the right, if deemed appropriate, to carry out any checks with the indicated reference facilitators.

Click the button to submit your application to receive an evaluation.

You will be contacted again by the organizers

Information provided pursuant to articles 13-14 of GDPR 2016/679 *

I consent to the processing of the data provided by NamMed S.r.l. in order to proceed with the evaluation and receive the communications necessary for its organization. I may revoke my consent at any time.

^{You can read the complete privacy policy at the following link : Privacy Policy}

Evaluation Request to Become a Metamedicine Consultant

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