Principles and Practice of Scoliosis Conservative Treatment

Welcome to the application for the World Master Course "Principles and Practice of Scoliosis Conservative Treatment".

Please submit this form only if you want to apply for the course. If you need more information before applying or if you have any questions about this application, please contact us at online.master@isico.it.

Special discounts for members/delegates of ISPRM/ESPRM/SOSORT, UEMS Board fellows and Board registered trainees, and for participants coming from Low and Lower-Middle Income Countries

The course next year will officially start in January, 2019. Thank you for your interest in this course organized by Isico. All fields marked with an * are mandatory.

Personal Information

First Name(*)

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Last Name(*)

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Country of citizenship(*)

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Street Address(*)

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City(*)

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Address(*)

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State

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Country(*)

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ZIp Code

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VAT Number (if needed for the invoice)

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Phone Number(*)

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Email address(*)

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Re-enter your email address(*)

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Language Proficiency

What is your Native Language? (*)

Mark below your proficiency in English (if you are a Native English Speaker, mark N/A for the questions below):

English Reading Proficiency(*)

High
Medium
Low
N/A Invalid Input

English Listening Proficiency(*)

High
Medium
Low
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Professional and Academic Information

Highest Degree
(e.g., MD, PhD, PT, etc.)(*)

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Year of Graduation(*)

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Current Position(*)

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Current Institution(*)

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Specialty(*)

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Number of Peer-reviewed
Publications (if you have not
published before, type 0) (*)

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Skills and Expertise

We ask you some questions about your current experience in the conservative treatment of patients affected by vertebral deformities (mainly scoliosis, hyperkyphosis).

Approximately, how many patients affected by vertebral deformities did you visit last year? *

(*)

> 1000
From 100 to 1000
From 10 to 100
Less than 10 Invalid Input

Approximately, how many braces did you prescribe last year? *

(*)

> 1000
From 100 to 1000
From 10 to 100
Less than 10 Invalid Input

Do you usually work together with an orthotist for the design and the final check of the braces? *

(*)

Yes
No Invalid Input

Do you usually work together with physical therapists for the treatment of your patients? *

(*)

Yes
No Invalid Input

In order for us to understand if you are familiar and would adapt well to a distance-learning program and also your group work skills, please respond to the statements below (your responses will not influence your acceptance into the program):

Please rate your level of computer expertise(*)

No experience Novice Intermediate Expert Invalid Input

I can devote 5-7 hours every two weeks to the course, in addition to the 1-hour live lesson. *

(*)

Yes
No Invalid Input

I use email, phone and text messages frequently in my work. *

(*)

Yes
No Invalid Input

I can download software from the web and install applications with no need for assistance. *

(*)

Yes
No Invalid Input

The reasons I am applying for this course are (mark all that apply): *

(*)

Personal interest (learning more in this area)
Requested by my supervisor
Offered through my university or other organization
Because of the program content
Because of the faculty
Because it is offered by/accredited by ISICO
Because of the certificate at the end of the course Invalid Input

How did you hear about this course?(*)

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I agree and recognize that the videos and their contents are protected by copyright hold by the authors who have the exclusive legal right to distribute the matter and form of it.
ISICO does not keep any right on the uploaded material.
By enrolling in the course, participants commit to not distribute to third parties the contents of the Course (scientific papers, videos, forum discussions Invalid Input

Payment

Course fee:

Registration fee 3000 Euros

Special discounts

Members/delegates of ISPRM/ESPRM/SOSORT, UEMS Board fellows and Board registered trainees have the opportunity to register with the special discount of 20% on the official fees (2400 Eur).
If you are eligible for this discount, please add your position (fellow/registered trainees/member/delegate) in the final field of the form

Residents in PRM register with the special discount of 50% on the official fees (1500 Eur).
If you are eligible for this discount, please send us a document to prove it.

People coming from Low and Lower-Middle Income Countries are eligible for these special discounts:
- Lower-Middle Income Countries: 50% (1500 Eur)
- Low Income Countries: 80% ( 600 Eur )

For participants resident in Italy, payment of VAT in addition to the current valid fee is compulsory

The payment must be done via bank wire, to:

Bank account issued to: Isico Tecnologie Servizi srl
Bank Name: Banco Di Desio E Della Brianza, Branch of Vigevano
Bank Address: Via Decembrio, 27029 Vigevano Italy
IBAN : IT18 Q034 4023 0000 0000 0276 900
SWIFT/BIC : BDBDIT22

Please advise your bank to debt you with the banking charges and send a copy of the wire receipt to online.master@isico.it
Once the course started it will not be possible to receive any reimboursement due to cancellation.

Notes

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