The United States Golf Association Foundation
Resource Center for Individuals with Disabilities
 
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Medical Community Database


Medical Community (Therapist) Sign-up

 Therapist helping young man in wheelchair
To best assist helping individuals with disabilities learn and experience golf, the Resource Center has determined that members of the medical community can be as helpful as potential golf instructors. The Resource Center is compiling a directory of members of the medical community who are willing to work toward making golf more accessible. These professionals can use their knowledge of kinesiology in helping an individual learn how to swing a golf club better or using their medical background to pursue studies that can show the benefits of golf for individuals with disabilities. If you are a member of the medical community, and would like to join in our efforts, please fill out the information below. If a question has an asterisk, it signifies that the question is optional.
 
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First Name:
Last Name:
Medical Speciality:
Contact Phone:
( )  -   Ext.
Contact Address:  
street
city
state
zip
Contact Email:
 @ 
Contact Fax:
( )  -
 
Do you work at a medical facility?
Yes (you must complete facility information)
No
 
If so, please specify below:
  Facility Name:
  Facility Address:
  Facility Web Site: http://
 
Please list your professional certifications/credentials:
 
Personal Golf Experience (check all that apply)
Completed training/seminar
Play golf
Provided golf-specific therapy for a golfer
Worked with a golf program
 
How did you become interested in learning more about helping individuals with disabilities play golf:
Client
Program at your facility
Reading publication/newsletter/web site
Self-directed interest
Word of mouth from other therapist
 
If you have been involved with a golf program, please answer the following:
  Program Name:
  Length of involvement:
  Please check any that describe your involvement with this program:
 
  Helped fund program
  Provided golf instruction
  Provided golf-specific therapy for participant
  Referred clients to participate in program
  Studied impact of golf on participants of program
  Volunteer
 
Please list suggestions you would have for us to get information about the Resource Center for Individuals with Disabilities to others in the medical field, particularly professional therapists:
 
Publications/Newsletters:
 
National Organizations:
 
Other:
 
Please list any ways in which you believe you might be able to help the Resource Center in its mission of making golf more accessible for individuals with disabilities:
 
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Thank you for entering your information. By completing this form, you give the Resource Center permission to post this information onto our Web site so that potential clients and/or other members of the medical community can contact you. A member of the Resource Center staff may contact you to ask you questions about the information you have entered before it is listed on the Web site. We thank you for providing this information, as we believe it will be helpful to golfers with disabilities throught the country.

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