Request a Workshop Today's Date(Required)MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2024202520262027FULL NAME(Required) First Last EMAIL(Required) ORGANIZATION(Required) ORGANIZATION WEBSITE(Required) ADDRESS(Required) Street Address City AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country HAVE YOU REVIEWED OUR COURSE DESCRIPTIONS?(Required)Here are our course descriptions: https://talktools.com/pages/opt-course-descriptions YES HAVE YOU REVIEWED THE NEW LEVELS PROGRAM REQUIREMENTS?(Required)We highly recommend our Workshop Partners familiarize themselves with the new structure and requirements for our Level Training Program: https://talktools.com/pages/talktools-levels-training-program-updated YES WHAT COURSES ARE YOU INTERESTED IN HOSTING?(Required)here are our available course descriptions: https://talktools.com/pages/opt-course-descriptions 3-Part Treatment Plan for OPT (Oral Placement Therapy) - Level 1 requirement OPT: Assessment and Program Plan Development - Level 1 requirement Superpowers of the Sensory System - Level 2 option Feeding Therapy: A Sensory Motor Approach - Level 2 option Motor Speech Series: Diagnosis and Treatment (expanded Apraxia course) Level 2 option Eating and Swallowing: A Global Approach - Level 2 option Feeding Foundations: Kaleidoscope Model - Level 2 option Feeding Therapy: A Sensory Motor Approach (Level 2 option) Functional Assessment & Remediation of TOTs - Level 2 option MYOTools 101/MYOTools 102 - Level 2 elective Level 3 Level 4 SPECIAL EVENT (a course that is not listed above) WHAT INSTRUCTOR ARE YOU REQUESTING(Required)Note: Some of our instructors teach several of our courses; other instructors teach specific courses VANESSA ANDERSON SMITH (3-Part Treatment Plan; OPT: Assessment and Program Plan Development; Feeding Foundations) LINE AVERS (3-Part Treatment Plan for OPT; OPT: Assessment and Program Plan Development) TAMARA CICILIANI (3-Part Treatment Plan for OPT; OPT: Assessment and Program Plan Development) -CROATIAN FREDERIQUE DUMONT (3-Part Treatment Plan for OPT; OPT: Assessment and Program Plan Development) - FRENCH CARMENZA HERRERA (3-Part Treatment Plan for OPT; OPT: Assessment and Program Plan Development) - SPANISH ROBYN MERKEL WALSH (MYOTools 101, MYOTools 102; Functional Assessment & Remediation of TOTs (Tethered Oral Tissues) - VIRTUAL ONLY) LORI OVERLAND (Feeding Therapy: A Sensory Motor Approach; Functional Assessment Remediation of TOTs/Tethered Oral Tissues) MONICA PURDY (3-Part Treatment Plan for OPT; OPT: Assessment and Program Plan Development; Feeding Foundations: Kaleidoscope Model; Superpowers of the Sensory System; Level 3; Level 4) RENEE ROY HILL (3-Part Treatment Plan for OPT; OPT: Assessment and Program Plan Development; Eating, Swallowing: A Global Approach; Motor Speech Series: Assessing and Treating; Level 3; Level 4) RISCA SOLOMON (3-Part Treatment Plan for OPT; OPT: Assessment & Program Plan Development REHAB ZAYTOUN (3-Part Treatment Plan for OPT; OPT: Assessment & Program Plan Development; Feeding Foundations) - ENGLISH AND ARABIC REQUESTED START DATE(Required) MM slash DD slash YYYY REQUESTED END DATE(Required) MM slash DD slash YYYY WORKSHOP FORMAT(Required) Virtual In-Person IF YOU ARE REQUESTING A SPECIAL TRAINING EVENT (A COURSE THAT IS NOT LISTED ABOVE), PROVIDE YOUR PREFERRED INSTRUCTORNOTE: We will try to accommodate your request for a specific Instructor for this Special Event request, but we cannot guarantee this request IF YOU ARE REQUESTING A SPECIAL EVENT, PROVIDE THE EVENT TITLE IF YOU ARE REQUESTING A SPECIAL EVENT, PROVIDE THE ESTIMATED NUMBER OF HOURS ANY ADDITIONAL DETAILS WE NEED TO KNOW?
