Join our network of highly trained Healthcare Providers and stay up-to-date on the latest research developments and practice guidelines in the concussion management space. In addition to a practice listing on our website, qualifying Practitioners receive access to our resource library, discounted courses, free webinars, practice support, research articles, newsletters, affiliate/supplier discounts, and more!

Click here to view our Membership Brochure for more information on how to become a Shift Concussion Management Provider. Note that practitioners must successfully complete both the Level 1 and Level 2 course streams in order to qualify.

When you’re ready to join, simply complete the Membership Application and a Shift Representative will review your eligibility and contact you!

Personal Information

Clinic Location 1

Clinic Location 2

* Designation:








*Although we recognize that it takes a broad team of health disciplines to adequately address the complexities of persistent concussion cases, our membership is geared best to primary contact clinical medical-rehab professionals. If your health discipline does not appear in the above list, leave a note in the "other" section and one of our representatives will be in contact with you to determine your eligibility.

* When did you complete Shift's Level 1 course "Best Practices in Concussion Management?"



* When did you complete Shift's Level 2 course stream?



PRACTICE INFORMATION

Help us learn more about your practice style, setting and healthcare team.

* In what type of clinic is your practice based?






* Which healthcare disciplines currently work within your clinic/facility (select all that apply):










* As part of your multidisciplinary environment, which healthcare disciplines have you utilized or recommend to your concussion patients when needed (either within your own facility or outside in your community?) (select all that apply):
















* Do you have a formal relationship when it comes to referrals, collaboration, inter or intra-office communication with any of the following professions (either within your own facility or outside in your community) as it pertains to concussion patients? (Ie. is there open and direct communication back and forth regarding a shared patient's rehabilitation plan)


















* Have you completed any additional Concussion continuing education/training outside of Shift's program?