NES Clinic Video Upload Entry Form

* = required

INSTRUCTIONS: After filling out the information below, you will see a “drag files here” icon. Alternatively, you can click the browse file hyperlink to browse your device (phone or computer) and click on the video you wish to upload.

PLEASE NOTE: If you are uploading for a family member/loved one, please use the individual’s name who has NES and is in the video so our team can correctly identify who the video belongs to.

For questions, please email: