NWHSU logo Alumni Student Referral Form


Do you know someone who is interested in attending Northwestern Health Sciences University? Please use the form below to send us contact information for the prospective student. Each prospective student will receive a complete packet of information, including a program brochure, suggested prerequisites and the University catalog. You can also contact the Office of Admissions toll free at 1-800-888-4777, or by e-mail at admit@nwhealth.edu. Thank you for your referral!

(* indicates required fields)

*Your Name 
Your E-mail 
*Student's Name 
Student's E-mail 
*Street Address 
Street Address 
*City 
*State/Province 
*Country 
*Postal Code 
Phone Number 

*Which Northwestern program is the prospective student interested in?

    Chiropractic
    Acupuncture and Oriental Medicine
    Massage Therapy

What best describes the prospective student's interest in the program(s) at this time?

    Initial interest, just gathering information.
    Has thought about a career in natural health care for some time; investigating alternatives.
    Has some knowledge about natural health care and considering pursuing it as a career.
    Definitely interested in natural health care as a career; evaluating colleges to attend.
Is the prospective student still in high school?
    Yes
    No

College or university the prospective student is currently attending (if applicable).

*Do you have a date in mind for when the prospective student would like to enter a program at Northwestern Health Sciences University?

    Yes
      If yes, please indicate the month and year
      May (Massage Therapy only) 2010
      September 2010
      January 2010
    No
Any questions we can answer for you?  Please enter your questions in the box below or give us a call at 1-800-888-4777.

   
 

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