APTA Orthopedics Involvement Form
1.
YES! I want to get involved in the APTA Orthopedics! I’m most interested in (check all that apply):
Continuing Education
Finance
Government Affairs
Judicial
Membership
Nominating
Publications
Public Relations
Reimbursement
Technology
Clinical Practice Guidelines
Other (please specify)
2.
I am interested in participating/working with the following Special Interest Group(s):
Occupational Health
Foot & Ankle
Pain
Performing Arts
Imaging
Animal Physical Therapy
Orthopaedic Residency/Fellowship
3.
I am interested in participating/working with the following engagement communities:
Students
Health Promotion and Wellness
Physical Therapist Assistants
4.
What is your preference regarding time commitment during involvement?
Short term project
Long term project
No preference
Other (please specify)
5.
Do you have any experience working with committees, task forces or special interest groups? If yes, please list below:
*
6.
Your name:
(Required.)
*
7.
Your APTA ID number:
(Required.)
8.
Your Mailing Address:
*
9.
Your email address:
(Required.)
10.
Your daytime phone:
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