Your Name:
Daytime Phone:
Fax:
E-mail Address:
Medical Specialty:	PT/PTA OT/COTA CHT ATC Physician Other
Years of Experience:	0-5 years 6-10 years 11-15 years 16-20 years more than 20 years
Employment Setting:	Acute Care Hospital Inpatient Rehab / SNF Health system or hospital-based outpatient Private outpatient or group practice Home care Other
Session 1	Workshop
First Choice	1. Clinical Exam of the Shoulder and Elbow 2. Cadaver Anatomy Specimens 3. Manual Techniques to Improve ROM and Strength 4. Taping Techniques for Shoulder and Elbow 5. Instrument Assisted Soft Tissue Mobilization 6. Cervical vs Shoulder/Elbow Pain
2nd Choice	1. Clinical Exam of the Shoulder and Elbow 2. Cadaver Anatomy Specimens 3. Manual Techniques to Improve ROM and Strength 4. Taping Techniques for Shoulder and Elbow 5. Instrument Assisted Soft Tissue Mobilization 6. Cervical vs Shoulder/Elbow Pain
3rd Choice	1. Clinical Exam of the Shoulder and Elbow 2. Cadaver Anatomy Specimens 3. Manual Techniques to Improve ROM and Strength 4. Taping Techniques for Shoulder and Elbow 5. Instrument Assisted Soft Tissue Mobilization 6. Cervical vs Shoulder/Elbow Pain
Session2	Workshop
First Choice	1. Clinical Exam of the Shoulder and Elbow 2. Cadaver Anatomy Specimens 3. Manual Techniques to Improve ROM and Strength 4. Taping Techniques for Shoulder and Elbow 5. Instrument Assisted Soft Tissue Mobilization 6. Cervical vs Shoulder/Elbow Pain
2nd Choice	1. Clinical Exam of the Shoulder and Elbow 2. Cadaver Anatomy Specimens 3. Manual Techniques to Improve ROM and Strength 4. Taping Techniques for Shoulder and Elbow 5. Instrument Assisted Soft Tissue Mobilization 6. Cervical vs Shoulder/Elbow Pain
3rd Choice	1. Clinical Exam of the Shoulder and Elbow 2. Cadaver Anatomy Specimens 3. Manual Techniques to Improve ROM and Strength 4. Taping Techniques for Shoulder and Elbow 5. Instrument Assisted Soft Tissue Mobilization 6. Cervical vs Shoulder/Elbow Pain
If someone other than yourself (i.e. an employer) will be paying for this course with their credit card, please provide their name:

***Please note, you will receive immediate email confirmation of your payment from Paypal. Your course confirmation email and further information regarding the course will be processed and emailed to you within 72 hours of receiving your payment.