Alumni – Stay Connected | Physical Therapy

CONTACT INFORMATION

First Name*

Last Name*

Maiden Name

Email Address*

PROGRAM COMPLETED

Year of Graduation or Completion:*

EMPLOYER INFORMATION

Current Employer*

Employer City, State, Zip*

City

*

State

*

Zip Code

TYPE OF EMPLOYMENT

Inpatient:

Acute Care Hospital

Pediatric

Rehab

Outpatient:

If academia, please specify name of institution:

CERTIFICATIONS

ABPTS Certifications:

Certified Cardiovascular & Pulmonary Specialist

Certified Clinical Electrophysiology Specialist

Certified Geriatrics Specialist

Certified Oncology Specialist

Certified Orthopedics Specialist

Certified Pediatrics Specialist

Certified Sports Specialist

Certified Women's Health Specialist

Other Certifications:

COMMUNICATION PREFERENCES

Select communications you would like to receive:*

Patients seeking PTs in your area

UDPT events

UDPT continuing education

UDPT research news and updates

OTHER NEWS & UPDATES

Other news and/or updates you would like to share with us:

UDPT ALUMNI -- STAY CONNECTED!