Hesch Institute Distance Learning

Distant Learning Registration

Please read the Distance Learning Program information here, then fill out the form below to register.

The registration form can also be printed from the Distance Learning document and emailed, faxed, or mailed.

Distance Learning Registration

Name *

First

Last

Title *

Facility *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Is the Above Address: *

Home Office

Home Phone *

Office Phone *

Cell Phone *

Best Phone # To Call: *

FAX *

Time Zone / Best Time To call *

If signing up with another clinician, their name (separate registration required) *

Registration Fee: *

Shipping & Handling Fee *

Method of Payment *

PRE-COURSE QUESTIONNAIRE: Area of Clinical Focus? *

Years of Experience? *

How long have you been treating the pelvis / SIJ? *

What is your day to day approach to treating the pelvis / SIJ? *

Average number of clients per week with pelvic / SIJ problems? *

Do you make a distinction between 'SIJ Dysfunction' and dysfunctional pelvic biomechanics? *

Describe your comfort level in treating the pelvis and SIJ. *

Describe your comfort level in identifying and treating sacral torsions. *

I have read the Distance Learning Program Packet and agree to all terms and conditions therein. *

I Agree

Submit

Registration is a 2-step process. Please click the "SUBMIT" button to send your registration information BEFORE clicking the "PAY NOW" button for online checkout.

Seminar Comments

"I enjoyed the course and feel like it will help me in the training room. It will give me a systematic way of looking at lumbar-pelvic-hip issues."
William B Sevening, AT, San Antonio Spurs, TX

Distant Learning Registration

Distance Learning Registration

Seminar Comments

SECURE CHECKOUT: