Request an Inservice Webinar Use this form to request a one-hour live inservice webinar from Clinical Support Specialist Colleen Finnoff! Your Contact InfoName* First Last Email* Enter Email Confirm Email Facility / Clinic / Organization* City* State* Phone*About Your Event...Is your facility equipped for a webinar?*We use the GoToMeeting (GTM) video conferencing platform. Will that work in your facility's technical environment? (We always do a trial run 7-10 days before the event, to be sure.)Yes, we use GTM all the time - no worries!I think so, but I'll check with the IT folksI don't know - but I'll checkNo, we can't use GTM - are there other options?How many attendees do you expect?*How many physical therapists, occupational therapists, orthotists and other clinicians will be attending your webinar?Please enter a number from 6 to 30.Target Date (Optional)If you have a specific target date in mind, please indicate it here. THIS IS NOT A COMMITMENT OR A RESERVATION GAURANTEE; it just gives us an idea of when you would like to hold the webinar. We'll be in touch within two business days to discuss scheduling options. MM slash DD slash YYYY About Your Clinic/Team/Practice...What is the age range for the majority of your client base?* 0 - 18 months 0 - 3 years 3 – 12 years 12 – 18 years Over 18 years Early Intervention involvement*Are your clients participating in (or eligible for) your state's Early Intervention (EI) program(s)? Yes No Common Indications & Diagnoses*What are the THREE most common indications or diagnoses that your team addresses for your clients? Ataxia Balance deficit Cerebral palsy Developmental delay Diplegia / Hemiplegia Hypotonia Internal/external leg rotation Kyphosis/Lordosis Postural control/alignment issues How familiar with TheraTogs is your team? We use TheraTogs often Some of us have used TheraTogs a few times, but we aren't confident as a team We've heard about TheraTogs, but never used them This will be the first introduction to TheraTogs for most or all of us You're not a bot, right?*What's the missing letter: TheraTo__s PhoneThis field is for validation purposes and should be left unchanged.
