PELVIC CARE FOR POC | HERMOSA BEACH

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REGISTRATION FORM

NAME *
NAME
PHONE NUMBER *
PHONE NUMBER
BIRTHDAY *
BIRTHDAY
I UNDERSTAND THIS DAY RETREAT FOR POC WILL BE FILMED AND PHOTOGRAPHED *
I understand that the content presented at PELVIC CARE FOR PEOPLE OF COLOR (POC) | A DAY RETREAT is for informational purposes only and should not replace seeking medical attention from a physician or skilled rehabilitation services from a physical therapist. I understand I must consult with and be cleared by a physician before engaging in any exercise program or before attempting any suggestions described or presented at PELVIC CARE FOR POC *