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APPLICATION FOR EMPLOYMENT Student/New Graduate (<2years) Chiropractor Lydian Center for Innovative Medicine 777 Concord Ave, Suite 301 Cambridge, MA 02138 www.lydiancenter.com Fax (617) 876-9011 Name: (Last) (First) (Middle) Address: (Street) (City/State) (Zip Code) Phone Number: ( ) E-mail Address: Social Security No.: License Number: Are you a: U.S. Citizen Permanent Resident Other* * If other, please provide documentation for eligibility to be employed in the U.S. Education Pre-Professional Education: List, in order, Colleges or Universities you have attended. Dates of Name of College Location Attendance Degree Professional Education: List chiropractic schools(s) you have attended. Dates of Name of Chiropractic School Location Attendance Degree National Board of Chiropractic Examiners exam dates: Part I - Date of Examination Part II - Date of Examination Part III - Date of Examination Part IV - Date of Examination 1

Chiropractic Experience Please describe your chiropractic experience: Please describe any other relevant experience you may have (teacher, small business owner, work with children, etc.): Licensure If licensed in Massachusetts, please provide your license number: Do you have a license to practice chiropractic in any other state(s)? Yes No If yes, list states, dates and license numbers. State Dates License Number Have you ever been involved in a malpractice suit? Yes No If yes, please give the date and nature of case(s) and status of the suit, i.e. open, dismissed, closed with payment. Date Nature of Case 2

Have you been convicted of a crime in the past 7 years? (You are not obligated to disclose sealed or expunged criminal records.) Yes No If yes, please explain: References Please provide name and contact information for references from a 1) clinic advisor 2) academic advisor 3) character reference. Name Title Phone Number 1) 2) 3) Statement of Purpose Please attach a statement describing your interest in this position. I certify that all the information contained in this application is correct and to the best of my knowledge. (signature) (date) (printed name) 3

Employment Opportunity for Chiropractor Lydian Center for Innovative Medicine About The Lydian Center: The Lydian Center for Innovative Medicine is a group of seasoned practitioners pursuing new treatment techniques at the cutting edge of health care, education and human development. As a group we treat a broad range of conditions including: chronic pain and illness, structural instability (poor coordination, gross and fine motor skills), nutritional deficiencies, psycho-emotional trauma, developmental delays, sensory integration and learning problems. Our team is comprised of Chiropractors, Homeopaths, Energy Kinesiologists, Psychotherapists, a Craniosacral Therapist, and a Naturopath. This is a unique and truly exciting opportunity for the right chiropractor. Many of the practitioners at the Lydian Center have international reputations, have published books and scholarly articles, and as a group attract a wide array of interesting, intellectually stimulating cases. For more information on the Lydian Center, please visit www.lydiancenter.com Lydian Chiropractic: Lydian Chiropractic is the chiropractic practice housed at the Lydian Center. We currently employ two doctors and are seeking to expand to a total of four. We are a cash-only practice with a 3-month waiting list for new patients. We have a farreaching reputation in the Boston area, greater New England and even internationally and treat many of the most challenging musculoskeletal and neurological cases. We see patients already familiar with chiropractic as well as many patients new to chiropractic who have been referred by a healthcare or medical professional. Our patient base is highly educated and highly motivated. In addition to adults, we see families with a wide variety of special needs children (PDD NOS, high functioning Asperger s, ADD, developmental delays, learning disabilities, attachment disorder, etc.). Our success is due in large part to our remarkably effective, cutting edge chiropractic technique: Axial Stability Method (ASM). Position Summary: Training Period (3-4 months): Axial Stability Method (ASM) is the only chiropractic technique practiced at the Lydian Center. It is a combination of AK, SOT, Activator Methods and additional complex energy kinesiology techniques. This is an entirely non-force technique. We do no manual manipulations. A training period of 3-4 months is expected for a chiropractor already familiar with AK, SOT, and Activator Methods. There is no expectation that the successful candidate will be familiar with the specialized energy kinesiology techniques. Learning ASM involves a fairly steep learning curve and requires a strong commitment on the part of the candidate to acquire new skills and information rapidly. 4

Post Training Period: The initial training period will be followed by close supervision for as long as needed. An experienced ASM chiropractor will always be available for mentorship and consultation. Once completely trained, the successful candidate will work independently with patients in the context of our integrated team of practitioners at the Lydian Center. This collaboration among practitioners supports our on-going work of neuro-integration and overall wellness in clients. Clients will consist of children and adults with chronic pain and illness, developmental delays and learning difficulties, as well as a variety of other neurological disorders (e.g. brain trauma and seizure disorders). Given the considerable investment in training time, once the 60-day probationary period has passed, Lydian Chiropractic will expect to sign a 3-year contract with the successful candidate. Professional Skills and Qualifications: In addition to a solid understanding of anatomy/neurology/physiology and patient management, additional specialized skills will be needed. The following are the skills necessary to perform the work the position requires. We understand however that not all promising candidates will possess all of the skills/knowledge/experience listed below. Once hired, the ideal candidate will be prepared to apply themselves rigorously to fill any gaps in their current knowledge base. Curiosity and interest in learning and practicing ASM Academic excellence, rigorous linear thinking combined with well-developed kinesthetic abilities Prior experience with non-force techniques, especially SOT, Activator and AK Accurate muscle monitoring (AK) Basic understanding of kinesiology principles (pause lock, use of hand modes) Basic knowledge of Energetic Sciences (Acupuncture/Meridian and Chakra systems) Experience working with children Understanding of psychology, parent/child relationships, etc. Motivation and leadership skills Excellent communication/interpersonal skills and boundaries Emotional maturity Prior background in psychology, education, early childhood development a plus We are very open to training new graduates provided they have sufficient life experience/emotional development to meet the expectations of our sophisticated patient base. Older applicants are particularly welcome, as well as chiropractors who have had other previous life experiences: parents, teachers, artists, selfemployed people, etc. 5

Compensation: Lydian Chiropractic operates on a split fee basis with a paid training period. Bonus incentives, 4 weeks vacation and health insurance are part of the package. A chiropractor seeing 60 patients per week (~20 hours face-to-face patient time) can expect to make $75-80,000. We are a cash practice (no insurance filings) with electronic medical records and therefore almost completely free of paper work. 6