Thank you for your interest in our Men’s Sexual Health Therapy Training Course.

This form will help us prepare for your visit, customize your training, and offer support to integrate these services into your practice.

Email *

Mobile Number *

Practice Clinic or Name *

Website:

Street Address *

City *

State *

Country

Postal code

Clinical Experience:

Do you currently offer men’s health or sexual wellness services? *

Which therapies are you already using or familiar with? (Check all that apply) *

Clinical Interests:

Which procedures or protocols are you most interested in learning? *

PRP for Erectile Function

Penile Girth or Sensitivity

Patient Protocols & Consultation Workflows

Other

What is your main reason for attending this Men's Sexual Health course? *

Start a new men’s wellness program

Expand current services

Boost outcomes & patient satisfaction

Learn how to market discreetly and ethically

Training Preferences:

What type of training are you interested in? *

Private On-Site Training at my facility

Attending a Group Course at a RMA Location

What RMA Location(s) are you interested in attending? *

Preferred Course Date: *

Travel & Logistics Assistance:

Would you like assistance with any of the following?

Hotel Planning/Recommendations

Chauffeur Service / Local Transportation

Airport Pickup/ Drop Off

Other Travel Support

Make the Most of Your Visit:

To make your trip and training even more worthwhile, is there anything else we can offer or assist you with?

Marketing Support Offer:

Would you like a FREE basic marketing plan to help attract male sexual health patients? *

I agree to terms & conditions provided by the Regenerative Medicine Academy . By providing my phone number and email address, I agree to receive text messages and email notifications from the Regenerative Medicine Academy USA.

I agree to be contacted by a Regenerative Medicine Academy Representative to go over my goals and create the best Regenerative Medicine Journey.