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* 1. I am:  (check all that apply)

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* 2. On a scale of 5 - 1, five being highest interest and one being lowest, please rate what type of topics/modalities for which you are most interested in.

  5 4 3 2 1
Acupuncture
Adjustment Techniques
Chronic Pain
Dry Needling
Exercise Prescription
Functional Medicine
Internal Disorders
Myofascial/Soft Tissue
Neuro Muscular Skeletal Rehabilitation
Nutrition
Pediatrics
Women's Health Topics

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* 3. On a scale of 5 - 1, five being highest preference and one being the lowest, please rate the delivery method/format you prefer to participate in.

  5 4 3 2 1
Online
Hands-on, face-to-face workshop
Hybrid - some online and some face-to-face

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* 4. What type of format do you prefer?  Choose all that are of interest.

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* 5.  * If Two day - 12 hours, what is your time preference?  (Choose one)

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* 6. Please provide any other information you wish for the Continuing Education department at Logan University to consider.

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* 7. If you would like to be included in a drawing for a free Logan Symposium (April 13 - 16, 2023) registration, please provide your contact information.

For any additional comments or feedback, please email postgrad@logan.edu

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