Potential case studies must be submitted previous the completion of this form:

Your contact details
name
address
city / state
email
phone
seminar


Patient's information
Age of the patient
Gender of the patient M     F
Chief Complaint, general Signs & Symptoms
History of the Chief complaint: how long have they had it, when did it start, trauma history, what makes it better, what makes it worse, past treatments
Allergies
Medications and supplements currently used
Medical History-other diagnosis' the patient has, past surgeries
 


The speaker will review the above information and once approved the case for discussion, they will ask any pertinent questions.