check

Virtual Observation Hours Assessment

Complete this assessment to demonstrate understanding of the concepts discussed in the virtual observation hours event and receive your hours form to be submitted to PT schools. 

Click the button below to start.

Start

Question 1 of 9

Name

Question 2 of 9

Email Address

Question 3 of 9

Phone Number 

Question 4 of 9

Name of Undergrad University

Question 5 of 9

Have you attended a virtual observation hours event with Dr. Julia before? 

A

Yes

B

No

Question 6 of 9

Please list in detail 3 things you learned from this virtual observation hours experience.

Question 7 of 9

What would you say to someone who is curious about attending the next virtual observation hours experience with Dr. Julia? 

Question 8 of 9

Would you like to be contacted when the next virtual observation hours event is hosted? 

A

Yes please!

B

No thanks

Question 9 of 9

Would you like to learn more about The Pelvic Health Kickstarter Academy? The PHK Academy is the only self-paced Pelvic Health foundations course that includes 1:1 mentorship with a pelvic health PT in existence today and is has become a beloved community for over 60 students in the past year! 

A

Yes, tell me more!

B

Nope, I'm good.

Confirm and Submit