APTA Wisconsin PT of the Year Award

Thank you for taking the time to nominate a PT or PTA who has made a difference in your life or the life of a loved one! A copy of your letter will be sent to the therapist to notify them of the nomination. If your therapist wins the award you will be invited as a guest to the awards ceremony in April 2024 to support them as they receive the award in person.

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* 1. Nominator's Contact Information

Name

Email Address

Phone Number

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* 2. Nominee's Name and Clinic or Home Address

Name *

Company *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code

Please use either option 3 or 4 to submit your letter of support.

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* 3. Letter of Support (Type or Copy & Paste Option)

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* 4. Letter of Support (Upload Option)

Please upload your letter of support in PDF or Word format.

PDF, DOC, DOCX file types only.

Choose File