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IASI APPLICANT QUESTIONNAIRE

Please note that filling in this questionnaire is entirely voluntary, you may sign it or not, and no answer will have any bearing whatsoever on your application or membership.

We are simply seeking honest and accurate information so we can assess the position of the profession as a whole. Feel free to expand on your answers on separate paper, and also feel free to answer only those items you wish.

This is a long questionnaire with 30 questions, so thank you in advance for taking the time to fill it out.


YOUR PRACTICE

(01) What 'brand' of Structural Integration do you practice, or what is your school affiliation?  

(02) How many years have you practiced SI, and what was your profession before?  

(03) How many clients, approximately, have you taken through the ten-session series?  

(04) How many sessions constitute your basic series, if not 10?  

(05) Do you take photos or do any other structural documentation?

(06) How many SI sessions do you provide per average month and what do you charge?

(07) What percentage of your practice is 3rd-party payment (insurance)?  

(08) Do you identify yourself to the public primarily as an SI practitioner, or through another modality?  

(09) Are you nationally certified (NCBTMB)? Does your state/country require licensing?

(10) Do you teach structural bodywork or SI? If so, where and in what capacity?


YOUR TRAINING

(11) Primary teacher(s) and number of hours of training:

(12) In what areas do you feel your training was strong? Lacking?

(13) Does your school/program offer continuing professional support?


ETHICS / PROFESSIONAL BEHAVIOR

(14) Have you ever had a formal complaint lodged against you for unethical behavior?

(15) Has your license / certification ever been revoked?

(16) Do you feel confident in handling ethical / professional issues that arise in an SI practice?


YOUR FEELINGS ABOUT SI WORK

(17) What separates SI from other forms of bodywork / intervention?


(18) Is SI primarily a medical / psychotherapeutic / spiritual healing / educational modality?


(19) What future would you like to see for SI?



MEMBERSHIP INTERESTS

(20) What types of services would you like to IASI offer?


(21) What are your concerns about IASI?


(22) If IASI held a profession-wide symposium / meeting in late 2005, would you:

Definitely attend   Might attend   Unlikely to attend   Definitely not interested  

(23) Are you willing to help get IASI started by joining a working group?

Developing the Certification Process International Coordination
Continuing Education Guidelines Website Development
Creating the professional Journal Developing the Newsletter
Membership & Policy direction Fund Raising
Marketing / Graphic Design Trouble Shooting & Help Anywhere
Other:

(24) I have skill(s) to offer:  

(25) I have thoughts to share (see the address below
or phone Toll-free 1-877-THE-IASI (1-877-843-4274)):


(26) Name:
(27) Address:
(28) City:
(29) State:    (30) ZIP:  
(31) Country:
(32) Phone:
(33) E-mail:

 

 


Please click SUBMIT or use your browser's PRINT functionto print it out and return to:
IASI; P.O. Box 8664; Missoula, MT 59807, USA
[040620.1829MeV]