Affiliation Interest Form
Please answer the questions below if you’d like to be considered for affiliation with LoveStrong Wellness. LoveStrong has developed a mission statement that reflects our goals and vision to support prenatal and postpartum families. We have established criteria to determine services that reflect this vision, and your answers will help us consider eligibility.
Affiliation Criteria – In Office (or mobile)
- Serves the preconception, prenatal, postpartum, or pediatric populations.
- Provides services including, but not limited to, lactation, chiropractic, pelvic floor therapy, acupuncture, doula, naturopathic, massage, occupational therapy, mental health, nutrition, fitness, pediatrics, wellness, or other with admin approval.
- Received education for preconception, prenatal, postpartum, or pediatric population specialty from a school that is accredited by a nationally recognized accrediting organization.
- Has state licensure or formal certification for prenatal, postpartum, or pediatric population specialty provided.
- Has received approval by at least two affiliates of LoveStrong, including clinic director.
- Provides holistic and evidence-based services and/or education.

Affiliation Criteria - Classes
- Serves the preconception, prenatal, postpartum, or pediatric populations.
- Works within, but not limited to, lactation, chiropractic, pelvic floor therapy, acupuncture, doula, naturopathic, massage, occupational therapy, mental health, nutrition, fitness, pediatrics, wellness or other with admin approval.
- Received education for preconception, prenatal, postpartum, or pediatric population specialty from a school that is accredited by a nationally recognized accrediting organization.
- Has state licensure or formal certification for prenatal, postpartum, or pediatric population specialty provided.
- Has received approval by at least two affiliates of LoveStrong, including clinic director.
- Provides holistic, evidence-based, educational, or community type classes.
- Provides education or recreational class for moms, babies, fathers, caregivers, or families.

Preferred Community Partners
- Internal LoveStrong Referral Network
- Serves the preconception, prenatal, postpartum, or pediatric populations.
- Provides services including, but not limited to, lactation, chiropractic, pelvic floor therapy, acupuncture, doula, naturopathic, massage, occupational therapy, mental health, nutrition, fitness, pediatrics, wellness, or other with admin approval.
- Received education for preconception, prenatal, postpartum, or pediatric population specialty from a school that is accredited by a nationally recognized accrediting organization.
- Has state licensure or formal certification for prenatal, postpartum, or pediatric population specialty provided.
- Has received approval by at least two affiliates of LoveStrong, including clinic director.
- Provides holistic and evidence-based services and/or education.
- Maintains a collaborative relationship and communication with LoveStrong Wellness
- Is vetted and approved by provider in the same specialty, clinic director, and one other LoveStrong in office Affiliate to meet the affiliation criteria.