Contact Ergos Institute

Program Invitation

Thank you for your interest in Dr. Levine’s work. If you would like to extend a program invitation to Dr. Levine or an Ergos Faculty member, please complete the form below. We appreciate your patience, as we receive a high volume of inquiries and Dr. Levine’s availability is limited.

Wishing you well, and thank you for the meaningful work you do in the world.

Invitation

Proposed Program Date(s)

(write: 01/01/26 for January 1st, 2026)(if flexible, please write the date range)

Proposed Honorarium / Affiliate Information

(support staff will connect with you to ensure it meets the minimum requirements)

Proposed Program Format

(for Online, Faculty will join no sooner than 15 minutes prior to the start)

Proposed Program Type

(for interviews, questions in advance are required)

If Other for Proposed Program Format or Type, please list below

Proposed In-Person Program Location, if applicable

(in-person venue name and city/country)

If an Interview, who would be interviewing Dr Levine or the Ergos Faculty/Instructor?

Proposed Program Length

(60min, 90min, etc.)

Proposed Program Time(s) with Timezone

(ex: 3:30pm - 4:30pm Pacific)

Is your Date / Time / Length of Program Flexible?

Proposed Program Title / Topic

(program hosts are required to create all marketing materials - Ergos support staff will send you requirements, if booked)

Proposed Program Website / Sales Page

Proposed Program Audience Type

(ex: therapists, bodyworkers, medical, meditation, yoga, spiritual/religious, educators, general public, or mixed healers & public)

Proposed Program est. Audience Size

If Dr Levine is unavailable, due to his partial retirement, would you be interested in an Ergos Faculty member or instructor representing his work?

Is this your first time working with Dr Levine or his Ergos Faculty members/Instructors?

Other Pertinent Information about the Proposed Program?

Organization Name

(organizing company name)

Host Name, if applicable

(ex: the name of a Podcast host)

Organization City & Country

Type of Organization

If Other for Type of Organization, please list below

Organization Focus / Objective / Expertise

Organization Website

Organization e-mail list size & social media average audience size

Primary Contact Name

First Name

Last Name

Primary Contact Position

Primary Contact Email

Primary Contact Phone

Country

(###)

###

####

Secondary Contact Name & Email (marketing)

Third Contact Name & Email (technical)

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FAQ PAGE

General Inquiry Information

Dr. Levine does not offer private sessions, nor is he available by email or phone for a consultation.
Dr. Levine cannot write book reviews or dedicate time to outside research projects.
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First Name

Last Name

Email Address

Subject

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