HDR Employee Registration form for Minnesota workshops

Please complete form below to register for your workshop(s). 

	Name:  Address:  City or Town:  State/Province:  Choose a State Outside US / Canada Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Postal Code:  Phone:  Fax:  Email:  Title/Position: Facility: Status: On-Call 0-19 Hours 20-29 Hours 30-35 Hours 36+ Hours Replacement Needed? Yes No Proposed Replacement:     Please select the work shops you would like to attend: 1. Please select workshop Physical Agent Modalities - S12-05 Starting in the Middle: Enhancing Function through Trunk Control - S12-10 Hand Therapy Basics - S12-15 Introduction to Pelvic Pain - S12-20 Putting Kinesio® Tape Into Practice--The Basics - S12-25 Introduction to Pelvic Pain - S12-30 Introduction to Lymphology - S12-35 Psychology of Chronic Pain - S12-40 Typical/Atypical Motor Development - S12-45 Introduction to Pelvic Pain - S12-50 Evaluation and Treatment Strategies of the Lower Quadrant - S12-55 Cardiopulmonary Rehabilitation - S12-60 Stroke Rehabilitation: Immediate and Functional Start - S12-65 Improving Balance Rehabilitation Outcomes Using Yoga Asanas - S12-70 Trauma to Home: Healing the Severely Injured Patient with Therapy - S12-75 Introduction to Myofascial Release - S12-80 2. Workshop selection two Physical Agent Modalities - S12-05 Starting in the Middle: Enhancing Function through Trunk Control - S12-10 Hand Therapy Basics - S12-15 Introduction to Pelvic Pain - S12-20 Putting Kinesio® Tape Into Practice--The Basics - S12-25 Introduction to Pelvic Pain - S12-30 Introduction to Lymphology - S12-35 Psychology of Chronic Pain - S12-40 Typical/Atypical Motor Development - S12-45 Introduction to Pelvic Pain - S12-50 Evaluation and Treatment Strategies of the Lower Quadrant - S12-55 Cardiopulmonary Rehabilitation - S12-60 Stroke Rehabilitation: Immediate and Functional Start - S12-65 Improving Balance Rehabilitation Outcomes Using Yoga Asanas - S12-70 Trauma to Home: Healing the Severely Injured Patient with Therapy - S12-75 Introduction to Myofascial Release - S12-80 Your Comments: