FSI Application - Fertility Science Institute

DIRECTORY

The Fertility Science Institute Directory.

This is a free directory where medical professionals, allied health professionals and certified Fertility Awareness teachers and coaches can post their listing to provide support to women and men through a lifetime of fertility.

Add Your Listing

Are You a Miscarriage Ministry Registering as an Organization and not as an Individual?(Required)

Yes

Name(Required)

First Last

Credentials (list Credentials in specific FABMS later in application)(Required)

If Other, please specify below. * Please list certifications in specific FABMS in the FABM section below. * If you are certified to teach a specific FABM please choose FA - Fertility Awareness Educator and do not list in "Other". There will be additional options to expand on this in Specialties.

Other Credentials

I acknowledge that I have formal credentials in the above marked category(ies), they are up to date, and I can provide them upon request.(Required)

Yes

Specialties - Medical Professionals(Required)

If Other, please specify below. * List FABM Methods in FABM Section further down in application.

Specialties - FA Educators(Required)

If Other, please specify below. * List FABM Methods in FABM Section further down in application.

Other Specialties

Personal Phone (Not published! Office Use Only - this is how FSI will contact you.)(Required)

Personal Email (Not published! Office Use Only - this is how FSI will contact you.)(Required)

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Please upload your picture (original, to be deleted)

Max. file size: 50 MB.

Please Upload your picture

If you do not have a photo a generic one will be provided and used.

Published Information

Professional / Practice Name

Brief Practice Description

For privacy reasons, do you want the below street address shown on the website?(Required)

Yes

Note this is for street address only, City, State and Country will be shown.

Professional Address(Required)

Country Street Address City State / Province / Region ZIP / Postal Code

Professional Phone(Required)

Professional Email(Required)

Practice Website

Appointment Calendar Link

Do you have a calendar that people can sign up for an appointment on? Place that link here and we will have a "Schedule an Appointment" button on your listing.

Do you offer online services or online classes? (Not telehealth)(Required)

Yes

Do you offer telehealth services?(Required)

Yes

I offer Telehealth services in the following US states:(Required)

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Admin - I offer Telehealth services in the following US states:

Languages in which services are provided:(Required)

If you do not see your language above, please list in Other, as we periodically update the list.

Other languages spoken (not listed above)

Please indicate which FABMs you are formally trained in and/or certified to offer:(Required)

If Other, please specify below.

Other methods I am certified in

I acknowledge that I am certified in the above marked category(ies), they are up to date, and I can provide them upon request.(Required)

Yes

Please indicate which FABMs you are knowledgeable about (not including what you are certified in noted above), i.e. have received some training in and/or engaged in extensive study of the method(s):(Required)

If Other, please specify below.

Other methods I am knowledgeable in

Do you refer to FABM educators?(Required)

Yes

Please indicate instructors of which FABM you refer:(Required)

Additional Information

Are you interested in having an appointment calendar added to your listing but don't have a calendar and would like FSI to help?

Yes

I'd need more information

Are you interested in providing webinars / classes through Fertility Science Institute?

Yes

I'd need more information

Are you interested in being added to other directories?

Natural Womanhood

FACTS

CMA - Catholic Medical Association

MyCatholicDoctor

Did someone recommend you sign up? Let us know who!

Fertility Science Institute Principles

Please read and agree to the Fertility Science Institute Principles:

Fertility Science Institute specifically supports scientifically-based, all natural, fertility awareness based methods of family planning.
Fertility Science Institute does not support any action which intentionally damages or frustrates the normal function of a healthy, reproductive or other functioning part of the body.
Fertility Science institute does not support abortion, nor the referral for abortion.
Technological interventions (such as IVF) which separate conception from the marital act are contrary to the dignity of the human person and deny the basic right of every child to be conceived in an act of love between its mother and father.
Couples using FABMS have autonomy to determine the size of their own families based on their own physical, economic, psychological and social conditions.

I agree to and affirm that my services are aligned with the Fertility Science Institute principles.(Required)

Yes

I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately.(Required)

Yes

To help us further promote the directory - please take a moment to share why being on this directory or having a directory like this is important to you? We may use this quote and picture on social media. Therefore, if you would like to remain anonymous or not have your picture used, please indicate in the box below.

Thank you for your submission! Do you have any questions or comments?

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CCL Teacher (Hidden)

Yes - English (Colleen)

Yes - Spanish (Silvia)

Yes - International (Erick)

Yes - But updated personally

No - My Catholic Doctor Upload

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Medical or Not Medical (Hidden)

Medical

Not Medical