UDPT ALUMNI -- STAY CONNECTED! UDPT ALUMNI -- STAY CONNECTED! If you are human, leave this field blank.CONTACT INFORMATIONFirst Name*Last Name*Maiden NameEmail Address*PROGRAM COMPLETEDProgram Completed:* BS-PT MPT DPT PhD Postdoctoral researcher ResidentYear of Graduation or Completion:*Choose one:1974197519761978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023EMPLOYER INFORMATIONI am retired YesI work in a non-PT related field YesCurrent Employer*Employer City, State, Zip*City*State*Zip CodeTYPE OF EMPLOYMENTInpatient: Acute Care Hospital Pediatric Rehab OtherOtherOutpatient: Geriatric Home Health Neuro Ortho Pediatric - General Pediatric - School-based Pediatric - Sports Sports Women's Health Wound Care OtherOtherAcademia: YesName of InstitutionCERTIFICATIONSABPTS Certifications: Certified Cardiovascular & Pulmonary Specialist Certified Clinical Electrophysiology Specialist Certified Geriatrics Specialist Certified Neurologic Specialist Certified Oncology Specialist Certified Orthopedics Specialist Certified Pediatrics Specialist Certified Sports Specialist Certified Women's Health SpecialistOther Certifications:COMMUNICATION PREFERENCESSelect communications you would like to receive:* Patients seeking PTs in your area UDPT events UDPT continuing education UDPT research news and updatesOTHER NEWS & UPDATESOther news and/or updates you would like to share with us:This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.Submit