Hesch Workbook - Hesch Institute

BLOCK 72 HOURSThis is a deeper inquiry into lumbosacral motion coupling; and will explore it in all potentialpermutations, while reinforcing LS-S coupling learned in lesson 5.EVALUATING AND TREATING FAULTY LUMBAR MOTIONTREATMENT METHODSTABLE 3: FAULTY L5-S1 FLEXION DYSFUNCTION TREATMENTTABLE 4: FAULTY L5-S1 EXTENSION DYSFUNCTION TREATMENTBLOCK 81 HOURADVICE FOR ACTIVITIES OF DAILY LIVINGMUSCLE AND ARTICULAR REHABILITATIONMAJOR MUSCLE GROUPSSPECIAL TESTSGENERAL MOBILITY & FUNCTIONAL MOVEMENT TRAININGLOWER EXTREMITY ARTICULAR MOBILITY EVALUATION6

APPLICATIONI have reviewed the course description and agreement, and agree to all terms presented thereinDate _____________________Participant (print) ______________________________________________________________________Participant (signature) __________________________________________________________________Address _____________________________________________________________________________City _________________________________________ State __________________ Zip ___________Phones (circle best # to call)Home: _______________________________Cell: _________________________________Office: ______________________________Fax: ________________________________Best time to call: ______________________________________________________________Email: _______________________________________________________________________________Tuition for this distance learning program is $349.00. This is a significant savings in comparison with theprice of the 2-day Hesch Seminar. If you are able to partner with another clinician, learning will begreatly facilitated. If signing up with another clinician, a discount is provided to both parties and tuition is$299.00 each.Payment Method (check one; listed in order of preference):____ Check ____ Credit Card ____ Purchase OrderCharge card: please circle (Visa MasterCard American Express)Card number: _________________________________________________________________________Expiration date: (MM/YYYY) ____________________Security Code: _________________Billing: (check if same as above) _____ SAMEAddress _____________________________________________________________________________City _________________________________________ State __________________ Zip ___________7

PRELIMINARY QUESTIONAIRE1. Practice and area of clinical focus: __________________________________________________________________________________________________________________________________2. Years of Experience_______________________________________________________________3. Educational Level (Degree /Title)____________________________________________________4. How long have you been treating the pelvis and SIJ? _____________________________________5. What is your day-to-day approach to treating the pelvis and sacroiliac joint (SIJ)?_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________6. In a given week, how many clients do you see with problems related to the pelvis and SIJ?_______________________________________________________________________________7. Do you make a distinction between “sacroiliac joint dysfunction” and dysfunctional pelvicbiomechanics? __________________________________________________________________________________________________________________________________________________8. Describe your comfort level in treating dysfunction of the pelvis and SIJ. __________________________________________________________________________________________________________________________________________________________________________________9. Describe your comfort level in identifying and treating sacral torsions. ____________________________________________________________________________________________________________________________________________________________________________________CB 08/05/118