Melamed Institute Functional Training Application

I'm excited and honored to offer you a chance to apply for this life changing training. Functional Medicine Coaching is a POWERFUL way to help for a clinician! Learn how I created my successful practice much faster than I had to.

With Care,

Dr. Inna

Doctor of Pharmacy, Functional Medicine Practitioner, 2 time Best Selling Author, Gut and Hormones Expert.

First Name *

Last Name *

Email *

Phone *

Personal & Professional Background

1. What is your current role and area of pharmacy practice? *

2. How many years have you been practicing as a pharmacist? *

3. Have you had any experience or training in functional or integrative medicine? (If yes, please describe.) *

4. What drew you to pharmacy initially — and how has that evolved? *

Motivation & Alignment

5. Why are you interested in learning functional medicine? *

6. What made you apply for this particular training program? *

7. What specific challenges or frustrations are you currently facing in your career? *

Vision & Goals

8. Where do you see yourself professionally 1 year from now? *

9. What would success look like for you after completing this training? *

10. What kind of impact would you love to have on your patients or community using functional medicine? *

Commitment & Fit

11. Are you willing to dedicate at least 3–5 hours per week for training, implementation, and growth? *

12. Are you open to being coached, receiving feedback, and implementing what you learn? *

13. How do you handle challenges when learning something new outside your comfort zone? *

Business/Entrepreneurial Intent (optional)

14. Are you interested in building a side business or full-time practice in functional medicine?

15. Have you ever launched a wellness service, product, or consultation offering? (If yes, describe briefly.)

Final Question

16. Is there anything else you'd like to share that would help us understand your goals, mindset, or why you're a great fit for this program? *

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