Connection Agent Registration Form

Thank you for your interest!


Your registration form has been successfully submitted. Someone from SeekHealing will be in touch with you shortly.

Thank you for your interest in a partnership with SeekHealing to become a Connection Agent for your business or community. We are so excited to help you share your work with seekers who are healing from addiction and who may otherwise not have access to it.

Please fill out the application and click the submit button.

Someone from SeekHealing will be in touch with you shortly.

We look forward to working with you to make the world a more connected place.

* Required
Contact Information
Connection Booster
Once your application is processed, we’ll work with you individually to develop a contract that’s appropriate for your organization.
Organization Information
Other