Share videos - Shift Concussion

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Unique ID

What would you like to share?(Required)

Individual Exercise Videos

Pathway Collection of Videos

Select An Exercise Category

You can select one category at a time. Up to 3 maximum.

Select Pathway Category

Please select only one pathway category.

Select videos to add from

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Select pathways:

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Would you like to add another category?

Yes

No

Select a second Exercise Category

Select videos to add from

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Would you like to add a final category?

Yes

No

Select a final Exercise Category

Select videos to add from

– Fill Out Other Fields –

Who Are You Sending This To?(Required)

Patient first name Patient last name

Patient Email(Required)

Would you like to add a note in your email to the patient?

Yes

No

Add your note for

Here is a preview of the email you will be sending to {Who Are You Sending This To? (Patient first name):1.3} {Who Are You Sending This To? (Patient last name):1.6}

{Add your note for :34}

My Recommended {What would you like to share?:19}:
{Select An Exercise Category:44} {Select video exercises set 1:24} {Select a second Exercise Category:45} {Select video exercises set 2:48} {Select a final Exercise Category:51} {Select video exercises set 3:52} {Select pathways::33}

Thank you,
{Name check:59}