Recorded NISE-Stim® Courses Request

Thank you for your interest in our NISE-Stim® recorded courses. In order to make sure only qualified therapists take my course, I added the layer of review. I hope you don't mind. Please complete the form below to request permission to have access to our recorded courses. If you have any questions, please email us at NISE@spinalstim.net.

NEXT STEPS:

1. NISE-Stim® will reveiw your submission and confirm you have the appropriate professional background. If you are requesting to take Level 2A, we will confirm that you have previously taken Level 1.

2. Once approved, you will receive an email wtih a link to registrater for Level 1 or Level 2A.

Please Note: Level 2B is currently being updated and will be available soon.

Thank you,

NISE-Stim® team

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

City, State/Country in which you are licensed

Qualifications

If you selected "other medical professional" above, please tell us what your degree/training is in.

License number

What NISE-Stim® level would you like to take?

Have you taken NISE-Stim® Level 1

If you have taken NISE-Stim Level 1, what date and location did you take NISE-Stim® Level 1?

I acknowledge that all course materials, presentations, videos, documents, and recordings related to NISE-Stim® are the intellectual property of Gerti Motavalli, LLC, protected by copyright law.I agree that I will not teach NISE-Stim® courses, workshops, or training sessions to other therapists or professionals, nor will I reproduce, distribute, or modify any NISE-Stim® materials for instructional, promotional, or commercial use.I may, however, educate families, caregivers, and other professionals about what NISE-Stim® is, its purpose, and its general benefits—provided such communication does not constitute teaching or training in the NISE-Stim® method.

NISE-Stim® Level 1 and Level 2A Recorded Courses Request