DECEMBER 2-3, 2017NASHVILLE SCHOOL OF LAW

Attendee Name:________________________________________________________________________

Title: ❑ DC - TN Lic. #_____ ❑ CTA - TN Lic. #_____ ❑ CXT - TN Lic. #_____ ❑ CA

Membership: TCA Member? ❑ Yes ❑ No CAT Member? ❑ Yes ❑ No

Practice/Doctor’s Name:_________________________________________________________________

Office Phone:______________________________ Office Fax:_________________________________

Email:_________________________________________________________________________________

Office Address:_________________________________________________________________________

City:_________________________________________ State:_______ Zip:_______________

Emergency Contact:__________________________________ Relation Phone:____________________

❑ Check if you have a disability requiring assistance; please describe:_______________________________________________________________________________________________________________

PAYMENT OPTIONSTOTAL REGISTRATION AMOUNT ENCLOSED $______________

Check #_________ or � Gold Member Benefit

CC#:____________________________________

Exp:_________/_________

Billing Address (if different from above) _____________________________________________________________________________

Zip:____________ Name on Card:_______________________________________________________

Signature:_____________________________________________________________________________

PLEASE RETURN THIS FORM WITH PAYMENT TO:TCA | 2123 8th Avenue S. | Nashville, TN 37204

Fax 615-383-6233 | Phone 615-383-6231 | tca@tnchiro.comRegistration not valid unless accompanied by payment. All fees are non-refundable and non-transferable.

Please be aware that photographs may be taken throughout this event for use in futureTCA approved publications, promotions, presentations, and/or any other media formats.

DOCTOR REGISTRATION & FEE

12 Hours CE – (Sat. & Sun.)

Early Bird (Prior Nov. 17) Late/At Door (After Nov. 17)

� TCA Member: $250 � TCA Member: $300

� NON-Member: $350 � NON-Member: $400

8 Hours CE – (Sat. only)

Early Bird (Prior Nov. 17) Late/At Door (After Nov. 17)

� TCA Member: $170 � TCA Member: $220

� NON-Member: $240 � NON-Member: $290

4 Hours CE – (Sun. only)

Early Bird (Prior Nov. 17) Late/At Door (After Nov. 17)

� TCA Member: $85 � TCA Member: $135

� NON-Member: $120 � NON-Member: $170

6 Hours — Doctor Boundaries, Ethics & Jurisprudence (Sat.)**

� TCA Member/NON-Member: $150

SUBTOTAL DUE $____________

CTA/CXT REGISTRATION & FEE

CAT Membership (renewal or new)� Enclose application if new member

� $50

6 Hours CE — CTA (Sun.)

Early Bird (Prior Nov. 17) Late/At Door (After Nov. 17)

� CAT Member: $100 � CAT Member: $150

� NON-Member: $150 � NON-Member: $200

2 Hours —CTA/CXT Boundaries, Ethics & Jurisprudence (Sat.)**

� CAT Member/NON-Member: $75

SUBTOTAL DUE $____________

PRINTED NOTESIf you wish to receive printed notes,

please add $10 to your total.

� I want my printed notes at registration.

Only a limited amount of printed notes will beavailable for requests on-site.

**All notes for Boundaries/Ethics courses will be provided in printed format at no charge.

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NASHVILLE SCHO OL OF LAW4013 Armory Oaks DriveNashville, TN 37204

SOLUTIONS FORSUPPORTING

THE GUT MICROBIOME 12 Hours of DC Continuing Education Available

INSTRUCTOR: RONDA NELSON, PHD, ND, MH, CNCSpeaker Sponsored by Standard Process

LIFE HACKS FOR MORE ENERGY,LESS STRESS, TO MOVE BETTER & HURT LESS

6 Hours of CTA Continuing Education Available

INSTRUCTOR: JD HASENBANK, DC, CCSP

DOCTOR BOUNDARIES, ETHICS AND JURISPRUDENCE6 Hours of State Mandated Course Completion for New DC Licensees

CTA/CXT BOUNDARIES, ETHICS AND JURISPRUDENCE2 Hours of State Mandated Course Completion for New CTA/CXT Licensees

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PLEASE - ONE REGISTRANT PER FORM ONLY. THANK YOU!

SOLUTIONS FOR SUPPORTING THE GUT MICROBIOME 12 Hours of DC Continuing Education Available

INSTRUCTOR: RONDA NELSON, PHD, ND, MH, CNCDECEMBER 2-3, 2017: Saturday: 8am-5pm CT | Sunday: 8am–12pm CT

This course is designed to provide attendees with a general review of the entire gastrointestinal system with emphasis on the gut microbiota and its impact on overall health. Discussion will include current research on the relationship between thehealth of the body and the diversity of organisms which reside inside the GI tract. Attendees will review safe alternatives to antibiotics and the role of microbial-rich foods in improving overall physical health. Testing options will be discussed along with relevant case examples to further enhance concepts presented. Participants will have greater insight into the systemic ill-effects of digestive insufficiency on overall health and be better equipped to provide appropriate nutritional and lifestyle recommendations to promote healing and enhanced well-being.

OBJECTIVES/OUTCOMES:Upon completion of this course, attendees will be able to:• Describe basic components and general physiology of all parts of the

digestive system• Appreciate the crucial role of the microbiome and its impact on human health• Distinguish between upper and lower digestive disturbances based on

presenting symptoms• Recognize a variety of beneficial bacterial species which reside in the small

and large intestine• Explore the complex interplay between microbe-human interactions• Evaluate current research on the role between intestinal microbes and

infections, illnesses, mental dysfunction and a host of other pathologies• Consider the role gut microbiota play in the pathogenesis of gluten sensitivity• Recognize the common signs and symptoms for dysbiosis and SIBO• Understand conventional methods of treatment, potential side-effects of

pharmaceutical interventions and when an outside referral would be indicated• Recommend appropriate nutritional and dietary support for the five

most common digestive dysfunctions: Dysbiosis, SIBO, intestinalhyperpermeability, gluten sensitivity, and yeast/fungal overgrowth

ABOUT THE SPEAKER:Dr. Ronda Nelson has extensive training in the field of functional endocrinology, holds a PhD in holistic nutrition and is an accomplished master herbalist. She brings with her a wide range of expertise including, but not limited to, whole food nutrition, herbology, endocrine-related dysfunctions, digestion and functional blood chemistry analysis and interpretation. Dr. Nelson also works with a large population of lichens sclerosis patients and is sought out byother healthcare professionals to consults on more difficult cases.

In addition to a rigorous traveling and teaching schedule, she maintains two thriving practices. Restoration Health, in Redding, CA and Seattle Aesthetic in Seattle, WA. She has seen and consulted with thousandsof patients locally, nationally and internationally. She is a dynamic speaker and is a recurring keynote at national events for alternative medicine and nutrition.

LIFE HACKS FOR MORE ENERGY, LESS STRESS,

TO MOVE BETTER & HURT LESS6 Hours of CTA Continuing Education Available

INSTRUCTOR: JD HASENBANK, DC, CCSPDECEMBER 2, 2017: Saturday, 8am-3pm CT

Sometimes the best hacks in life are the simple ones; little modifications you never thought of but completely make sense once somebody teaches you, you put them to use and see the results. Learn these simple tips and tricks to upgrade your choices, habits, postures, preferences and overall lifestyle. Not only will you notice the improvements they make in your life; you will receive positive feedback as youteach them to your friends, family and patients.

ABOUT THE SPEAKER:Dr. JD Hasenbank’s goal in life is to help others move better andhurt less. He has a passion for empowering patients to be in controlof their body by utilizing self-assessment and self-directed therapy.He teaches them how to reset their tight muscles, release their myofascial adhesions and reprogram their poor posture, habitsand movement patterns.

He graduated from Texas Chiropractic College and is a Certified ChiropracticSports Physician and Functional Movement Specialist. He is trained in Strength & Conditioning, Corrective Exercise, Active Release, Assisted Isolated Stretching, Instrument Assisted Soft Tissue Mobilization, Dry Needling, Electro-Acupuncture, Cranio-Sacral Therapy, Spinal and Extremity Manipulation.

He has been in private practice for 16 years and worked with athletes in the NFL, NBA, MLB, PGA, NCAA & Olympics. He has also been able to care for some of Nashville's top musicians and performers.

CTA/CXT BOUNDARIES, ETHICS AND JURISPRUDENCE 2 Hours State Required Course Completion for CTA/CXT New Licensees

INSTRUCTOR: WENDY WILLIAMSDECEMBER 2, 2017: Saturday: 3pm-5pm CT

The Tennessee Board of Chiropractic Examiners requires all licensed Chiropractic Therapy Assistants (CTAs) and Chiropractic X-ray Technicians (CXTs) to attenda one-time, two (2) hour course. This course will cover sexual boundaries,risk management, and jurisprudence. This seminar is designed to help thenewly licensed CTAs define all issues surrounding those boundaries.

ABOUT THE SPEAKER:Wendy Williams entered the chiropractic profession in 1996.She obtained her CTA license in 2001 and has ten years of experience as an insurance CA in a busy chiropractic office. She served on the CAT Board of Directors and was honored with the 2004 CA of the Year award. Wendy joined the TCA staff in 2006 where she was the Operations Manager and assisted members with insurance andgeneral practice questions. She continues to support theTCA and CAT by contributing her time and talents administratively,at events and as a presenter on CA topics.

DOCTOR BOUNDARIES, ETHICS AND JURISPRUDENCE6 Hours State Mandated Course Completion for DC New Licensees

INSTRUCTOR: DR. MARY BABIAN DECEMBER 2, 2017: Saturday, 8am-2pm CT

The Tennessee Board of Chiropractic Examiners requires all newly licensed Tennessee Chiropractors to obtain a one-time six (6) hour Board approved course in risk management, sexual/professional boundaries, and Tennessee statutory and regulatory chiropractic jurisprudence. This course is designed to help the newly licensed chiropractor more clearly understand all issues surrounding the profession of chiropractic in Tennessee.

NEED CE? Two (2) hours of Saturday’s doctors program will be offeredto Doctor Boundaries attendees only, to be taken between 2pm and 5pm following your seminar. See registration form for details.

ABOUT THE SPEAKER:Dr. Mary Babian received her Bachelor of Science degree from the University of Tennessee at Chattanooga in 1974. Dr. Babian then received her Doctor of Chiropractic from Sherman College of Straight Chiropractic in 1978 and has been in private practice in Tennessee since that time. Dr. Babian earned her Doctor of Jurisprudencedegree from Nashville School of Law in 2000. Dr. Babian is active in her

community, volunteering on the Board of the local no-kill animal shelter and bringing care to underserved areas throughout her many years of practice. A long-time member of the TCA, Dr. Babian has also served her profession as instructor for this vital seminar for over 18 years, and in the process, has helped many physicians ensure solid foundations for successful practices.

*Please note that the Doctors New Licensee seminar on Saturday does not breakfor lunch. You may wish to bring small snacks with you for this seminar.

TCA NOTES GO PAPERLESS!Unless otherwise requested, all notes will be provided electronically.Prior to the seminar, we will provide registered attendees with access to download their notes online.

IF YOU WISH TO RECEIVE PRINTED NOTES, PLEASE ADD $10 TO YOUR TOTAL.❑ I want to pick up my printed notes at registration.

A limited amount of printed notes will be available for requests on-site.**All notes for Boundaries/Ethics courses will be provided in printed form at no charge.

KNOW BEFORE YOU GO: All seminar notes will be available online through TNChiro.com prior to the December Seminar for registered attendees. Once you have registered for this seminar, you will receive your confirmation with log-in information and directions to download your seminar notes. Please download your notes prior to attending the seminar.

LAPTOPS/IPADS WELCOME: Please feel free to bring your electronic device to view and follow along with your downloaded notes.