Apply for Gunn IMS Dry Needling Certification

Application for Part 1 of UBC Gunn IMS Certification

If you have questions regarding the application process please contact:
Judy Chen, cpd.info@ubc.ca, Phone: (604) 675-3777
For technical issues with form submission please email info@ubcgunnimsmembers.com

If you prefer, you may print off an application form and mail or email it to UBC CPD:
UBC CPD, Suite 200 East Tower, 555 West 12th, Vancouver, BC V5Z 3X7, cpd.info@ubc.ca

Online Application:

Applicants must be either a medical doctor or licensed physiotherapist. Please ensure you have all appropriate prerequisites before applying.

* Indicates required field

Healthcare Discipline *

Medical Doctor Physiotherapist

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

My preferred couse is: *

How did you hear about this course? *

This is a TWO PART certification course:
 Part 1 (4 day Course): $1850
 Part 2 (3 day Course): $1375
You will be contacted for a deposit of $1,000 at the time of registration; the balance of $850 is due one month before Part 1 and $1375 before Part 2. You must complete both Part 1 & 2 within one year to become a certified GUNN IMS Practitioner. You will be contacted regarding your approval for attendance at the course and once we have a placement for you in an upcoming IMS course, you will be contacted regarding payment options. PLEASE DO NOT SEND PAYMENT DETAILS WITH YOUR APPLICATION, AS YOU MAY NOT BE REGISTERED IN THE NEXT AVAILABLE COURSE.
UBC/Gunn IMS Course Cancellation Policy:
This course incurs significant nonrefundable expenses prior to the course— please read and carefully
understand our cancellation policy before submitting your registration. The Division of Continuing Professional Development reserves the right to cancel a course thirty (30) days prior to the course date. Each registrant will be notified by telephone, followed by written notification and a full refund. The University of British Columbia is not responsible for any costs, including, but not limited to, airline or hotel penalties. Should you need to cancel your registration, you must do so by email to cpd.info@ubc.ca one month before the start of the course. Your registration fee, less a $50 handling charge, will be refunded.
Registration Services provided by UBC CPD.
* Registration forms with missing or incomplete documentation will NOT be accepted.

Documentation

Further documentation is required. *

I will email copies of required documentation I will mail copies of required documentation I have uploaded copies of the required documents below

Current CV *

Max file size: 20MB

Copy of Degree *

Max file size: 20MB

Certificate /Letter of Good Standing from your College licensing authority OR copy of provincial licensing body of current practice if you are NOT registered in the province where the course is held. *

Max file size: 20MB

Copy of Malpractice Insurance up to $3 million per occurrence, effective in Canada. *

Max file size: 20MB

Physiotherapists only - Letter from your employer stating that you have at least 4 years of musculoskeletal therapy experience. *

Max file size: 20MB

Physiotherapists only - additional documentation of prerequisites (please click on question mark for acceptable options) *

Max file size: 20MB

You may also submit required documents to either:
cpd.info@ubc.ca or
UBC CPD, Suite 200 East Tower, 555 West 12th, Vancouver, BC V5Z 3X7

If available, a place on your preferred course will be held for 5 days while we await all documentation and application approval.

Acknowledgment: *

I understand my application will not be complete until all documents are received and I am contacted for payment details.

Submit