Team Participation Form

If you are unable to complete the form online, you may download as a pdf,
complete and email a scanned copy to julie@heartsinmotion.org or fax to (219) 922-1694.

Please also send a copy of your passport.

Online Team Participant Information Form

Please select the team that you wish to join:

Apr 30 2022

Physical Therapy Clinics (Dominican College)

May 13 2022

Cleft Lip/Palate surgery, Dental clinics, Iron testing, Diabetes testing, Construction (Washington State Univ.)

May 15 2022

Physical Therapy Clinics (Texas Women's Univ.)

Jul 31 2022

Occupational Therapy, Physical Therapy, and Speech and Language Pathology Clinics (Temple Univ.)

HEADQUARTERS

Phone: 219-924-2446
Fax: 219-922-1694
2210 US 41
Schererville, Indiana 46375
Click here to email

Guatemala Office

Barrio La Barca
Gualan, Zacapa
Guatemala, Central America

Kentucky Office

2601 Evergreen Wynde
Louisville, KY. 40223
Phone 502-523-2695
himlouisville@hotmail.com

Oklahoma Office

1203 East 30th Place
Tulsa, OK. 74114
Phone 281-684-9741
marciamcginnis@comcast.net

Wisconsin Office

S67 W32615 Ashton Way E
Mukwonago, WI. 53149
Phone 262-490-7009
heartsinmotionwis@yahoo.com

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