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Pediatric Balance Lab Inquiry Form

Thank you for your interest in the Pediatric Balance Lab at the University of Hartford. If you are interested in joining one of our research studies, would like more information about our lab, or are interested in our upcoming courses, please complete the form below.  A member of our staff will be in touch with you shortly. 

Required fields are marked with an asterisk *

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First Name: *

Last Name: *

Email Address: *

Phone Number:

Child's First Name:

Child's Last Name:

Child's Date of Birth:

Child's Gender:

Questions or Comments: