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. Date Format: MM slash DD slash YYYY About Your Clinic/Team/Practice...What is the age range for the majority of your client base?*0 - 18 months0 - 3 years3 – 12 years12 – 18 yearsOver 18 yearsEarly Intervention involvement*Are your clients participating in (or eligible for) your state's Early Intervention (EI) program(s)?YesNoCommon 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 oftenSome of us have used TheraTogs a few times, but we aren't confident as a teamWe've heard about TheraTogs, but never used themThis will be the first introduction to TheraTogs for most or all of usYou're not a bot, right?*What's the missing letter: TheraTo__sPhoneThis field is for validation purposes and should be left unchanged.
