Ancestral Medicine Payment Request Form

This is the place for submit a request for any type of payment or reimbursement from Ancestral Medicine. Ancestral Medicine makes payments on the 1st and the 15th of the month via Paypal upon receipt of this form. We’ll reach out if we have any questions, and you’ll also receive an email confirmation of your submission.

Payments for practitioner training support, online course support (with the exception of hourly-tracked work), and other scheduled contracts will be paid on the timeline provided in those agreements and will occur automatically (no need to fill out this form for those situations).

Please note: Compensation received by Ancestral Medicine for these services is considered independent contractor income. Any person eligible to work in the United States and earning $600 or more in contractor income within a calendar year will receive a statement of contractor income from Ancestral Medicine as required by U.S. federal law (1099-MISC) by January 31 of the following year. For those in that category, we will be in touch before the end of the year to request or confirm your tax information.

If you have any questions, please reach out to Marie at Thanks for your service!