CAPP Transfer Discount Application

CAPP PH1 or OBF Transfer Discount Application

Open to PTs, PTAs, and SPTs

Have you completed pelvic health physical therapy from another institution or education provider but wish to eventually pursue the distinguished Certificate of Achievement in Pelvic Health or Obstetric Health Physical Therapy?

We are offering a $150 Transfer Discount that you can apply toward an upcoming Pelvic Health Physical Therapy Level 1 webinar course or a Fundamental Topics of Pregnancy & Postpartum Physical Therapy webinar course if you have completed a similar/comparative course through an outside continuing education provider.

We're pleased to offer this opportunity to streamline your journey towards obtaining the CAPP-Pelvic Certification provided by the Academy of Pelvic Health Physical Therapy, a component of the American Physical Therapy Association.

Full Name:*

First NameLast Name

Designation

Physical Therapist (PT)Physical Therapist Assistant (PTA)Physical Therapist Student (SPT)

Primary E-mail Address:*

example@example.com

Alternate E-mail Address (Optional)

example@example.com

Please describe your membership status

I am a current APTA Pelvic Health memberI am a former APTA Pelvic Health memberI am a member of APTA national but not a member of APTA Pelvic HealthI am not a member of APTA nor APTA Pelvic Health

City, State

i.e. Los Angeles, CA

Information About the Course You Have Completed

Continuing Education Provider Name*

i.e. Company Name

Upload Your Transcript or signed Certificate of Completion that shows proof that you attended a similar level course*

Upload the Course Description, Objectives, Time Ordered Agenda of the course you attended so that we can verify the similarity between the courses. *

Which Academy PH1 or OBF Webinar courses would you like to apply your discount toward? Please list course title and date.*

Consent

By submitting this form, I acknowledge and consent to the following terms:

I certify that the information provided in this form is a true and accurate representation of myself and my continuing education transcript.
I understand that if it is discovered that false information has been submitted in this form, even after obtaining and using a discount code, the Academy of Pelvic Health Physical Therapy reserves the right to cancel my course registration and prohibit my participation in the course.
I understand that this discount code is not transferrable and cannot be combined with other promotional codes, excluding early-bird/advanced rates and membership-based discounts. Additionally, it cannot be applied retroactively to past course registrations.

By signing below and submitting this form, I confirm that I have read, understood, and agreed to these terms and conditions.

Signature*