Healthy Athletes Clinical Director Interest Form

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This form is to be filled out by health care professionals who are interested in learning more or becoming a Healthy Athletes Clinical Director.

Healthy Athletes is not only a program for athletes but, through training and hands-on experience at screenings, it is a program for health care students and professionals to increase knowledge of best practices in caring for people with intellectual disabilities.

Please, take a second to let us know which discipline you are interested in and provide us with your contact information.

Email *

Name (First & Last) *

Phone *

Please select the Healthy Athlete discipline you are interested in *

Fit Feet - podiatry screenings

FUNfitness - physical therapy screenings

Health Promotions: healthy lifestyle screenings

Healthy Hearing - audiology screenings

Healthy Young Athletes - developmental and physical exams for children ages 2-7

MedFest - physical exams

Opening Eyes - optometry screenings

Special Smiles - dental screenings

Strong Minds - emotional wellness screenings

Please list any licenses or certifications *

What county do you live in? *

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