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Pelvic Health Kickstarter Academy Application!

Please take a few minutes to fill out this short and sweet application!

The Pelvic Health Kickstarter Academy is the only online community of its kind providing Pelvic Health Education, 1:1 Mentorship, Networking, and Shadowing/Clinical Experience Opportunities to help you reach your full potential as a Physical Therapist! If you are interested in the exploring the world of Pelvic Health, then this is the place for YOU! 

**Please note, this application does not guarantee you a spot in the Academy. The Academy is an exclusive community for those who share our vision for increasing access to Pelvic Health services for all by spreading a message of hope and healing to every corner of the globe! If you share in our mission, are compassionate, driven, and ready to change our world, PLEASE apply! We would love to meet you! :)

Click the button below to begin our short + sweet application! 

Start

Question 1 of 10

Name

Question 2 of 10

Email

Question 3 of 10

Phone Number

Question 4 of 10

Why are you interested in learning more about Pelvic Health Physical Therapy?

Question 5 of 10

What is one of your biggest career aspirations/goals? 

Question 6 of 10

What has been the greatest obstacle holding you back from achieving your big career dream/goal?

Question 7 of 10

What is the most important thing in life/what drives you?

Question 8 of 10

The Pelvic Health Kickstarter Academy provides quality Pelvic Health Education, Resources, and Mentorship to help you explore one of the fastest growth fields in Physical Therapy!  What do you hope to achieve through your Academy experience?

Question 9 of 10

The Pelvic Health Kickstarter Academy offers TWO paths for you to choose from to best fit your needs! Which path to explore Pelvic Health PT are you most interested in??

A

World-Changer Package!

B

Discovery Package!

C

Hmm...I'm not sure!

Question 10 of 10

On a scale of 1-10, how ready are you to join the Pelvic Health Kickstarter Academy and take a big first leap towards your dreams?! (1- I'm not ready; 10 - HECK YES! Let's do this!!)

Confirm and Submit