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Apply Online

Download, print or complete our online application to start your journey with the 100% team. If you download, please print and complete your application and email to joy@100percentdoc.com or fax to 719-630-7683.

Download print version

We will contact you and set up a phone call with Dr. Jason Helfrich.

Partnership Application

Thanks for taking the time to discuss becoming part of our vision! We take our partner selection very serious and would like to get to know you a little better.

First Name required
Last Name required
Email Address required
Phone
Age
Address
City, State, Zip
School Attended/Attending
Graduation Date
Why did you choose the profession of Chiropractic?
Have you opened a chiropractic office before? If so, tell us about it.
Where would your dream practice be located? (top 3 places)
Why do you feel this is your ideal place to open your practice?
What are your strengths when it comes to building your dream practice?
What are some possible challenges when it comes to building your dream practice?
What is your adjusting technique of choice and why (X-ray, Corrective Care)?
We are looking for the absolute elite doc's of our great profession; the top one in every one thousand, ready to launch to success. Please explain why you fit in this category.
Tell us a little more about yourself…family, hobbies, goals, personality traits, etc.
   
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