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

Online Team Participant Information Form

Jan 25 2019

OB/Gyn surgery, General Medical clinics, Cervical Cancer screening, Firefighter Training, Vision Clinics, Helping Babies Breathe seminars and Construction

Feb 23 2019

 Physical Therapy Clinics (DeSales Univ. & Thomas Jefferson Univ.)

Mar 02 2019

 Physical Therapy clinics (Washington Univ. St. Louis)

Mar 08 2019

Cleft Lip/Palate Surgery, Dental clinics, A1C Testing, Construction, Physical Therapy Clinics, Public Health projects (WSU, Univ. of Pitt, Arcadia Univ.)

Mar 16 2019

 Physical Therapy Clinics (Univ. of Puget Sound)

Mar 22 2019

 Speech & Hearing clinics and Physical Therapy Clinics (Univ. of Washington, Albizu University, GROW UW)

Mar 31 2019

 PA Rotation # 11

Apr 08 2019

 Physical Therapy Clinics

Apr 26 2019

 Physical Therapy Clinics (High Point University)

May 04 2019

Occupational Therapy clinics (Washington University St. Louis)

May 07 2019

General medical clinics, public health projects, education (Arcadia University Physician Assistant Group)

May 17 2019

 Physical Therapy clinics (Texan Woman's Univ.)

May 17 2019


Ecuador: Physical Therapy Clinics

Jun 15 2019

 Good Shepherd Lutheran Church group: Construction projects

Jun 21 2019

 Construction Projects (Highview Church)

Jul 12 2019

Firefighter training, Vision clinics, Helping Babies Breathe seminars, Construction projects, Vacation Bible school, and possible general medical clinics

Jul 19 2019

Physical Therapy Clinics (GVSU),Construction projects (St. Michael's Catholic Church), and Vet clinics

Aug 04 2019

 Physical Therapy Clinics (Temple Univ)

Aug 13 2019

 Carroll University Physical Therapy Rotation

Aug 17 2019

Medical clinics and possible Audiology clinics (Salus Univ.)

Aug 24 2019

 Arcadia University Physical Therapy Rotation

Sep 07 2019

 Physical Therapy clinics (Drexel University)

Oct 11 2019

 Surgery, general medical clinics, and construction

Oct 18 2019

 Physical Therapy Clinics (ATI)


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

Oklahoma Office

1203 East 30th Place
Tulsa, OK. 74114
Phone 281-684-9741

Wisconsin Office

S67 W32615 Ashton Way E
Mukwonago, WI. 53149
Phone 262-490-7009