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Registration: Spine Assessment in Sports Medicine Presentation
Friday, July 20th, 2018. 12:30pm - 4:00pm.
Ottawa Osteopathy & Sports Therapy
2197 Riverside Drive, Suite 601
Ottawa, On. K1H 7X3
(613)521-3222
www.ottawaosteopath.com
Spine Assessment Presentation Registration
All information provided here shall not be used for newsletters, spam marketing etc. Contact information will be kept private and confidential.
1.
Please provide your first and last name.
2.
What is your specialty (ex: sports medicine, family medicine etc)?
3.
Please provide an email address for contact information.
4.
Please provide your phone number and indicate if this is a personal or clinic number.
5.
What is your clinic name and street address?
6.
How did you hear about this course?
Email from our clinic
Email from a colleague
Facebook
Word of mouth
Other
7.
Had you heard of our clinic in the past?
Yes
No