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TPTA 2013Meeting Exhibitors

UNIVERSITY OF TENNESSEEHEALTH SCIENCE CENTER - GOLD SPONSORNHC - GOLD SPONSORElectro-Medical EquipmentNorth Mississippi Medical CenterElectro-Medical EquipmentATI Physical TherapyRenfroe MedicalRehab Solutions, Inc.

SSeepptteemmbbeerr 2277--2288,, 22001133

ContinuingEducation

and Fall Meeting

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ScheduleFridaySeptember 27, 2013Anatomy for LE (20 people only)8:00am to 5:00pm with 1hr break for lunchWill be held at UTHSC7.5 Contact HoursRick Kasser, PT, PhD

Eclectic Approach to Manual Therapy8:00am to 12:00pm3.75 Contact HoursMark Temme, PT, OCS

Torticollis: diagnosis, treatment andEvidence Based Practice 8:00am to 12:00pm3.75 Contact HoursJodi Jennings, PT, DPT, PCS, Bertie Gatlin, PT, PCS, and Dr. David Spence

Determining Spine Exercise Prescription:PTA Decision Criteria:(A course strictly for PTAs only) 7:30am to 12:00pm4 contact hoursBaron Johnson, PT

Management of Severe Joint Diseaseand Chronic Illness: Lessons from theBleeding Disorder Population8:30am to 10:30am2 Contact HoursRuth Mulvany, PT, MS, DPT and Janet Tuller, RN, MPH

Deep Brain Stimulators & ParkinsonsDisease10:00am to 12:00pm 2 Contact HoursEllen Markwell, PT and Dr. Sillay

Box Lunch and Networking, etc. 12:00pm to 1:00pm

District Chair Caucus Meeting12:00pm to 1:00pm

TPTA Board Meeting1:00pm to 5:00pm

Evidence Based Management of Hip and Knee OA1:00pm to 5:00pm3.75 Contact HoursAdam Risinger, PT, OCS, Cert. MDT andCraig O’Neil, PT, DMT, OCS

Vestibular Rehab1:00pm to 3:00pm 2 Contact HoursMelanie Morton, PT, NCS and Teresa Murphy, PT

TPT-PAC Reception5:30pm to 7:00pm

UTHSC Alumni and Friends Reception5:30pm to 7:00pm

All events are to be held at the Peabody Hotel

unless otherwise stated.

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SaturdaySeptember 28, 2013Healthcare Reform, Healthcare Policy,Payment Policy, ACOs, Shared Savings,Where does the PT profession fit in?8:00am to 12:00pm 3.75 Contact HoursAlan Meade PT, ScDPT, MPT and Jason Richardson, PT, DPT, OCS

Pharmacology for the Physical Therapist:From Acute Care Transitioning toOutpatient8:00am to 10:00am2 Contact HoursAdam Shoop, PharmD and Tara Newtown, ParmD

Ethics9:00am to 11:00am2 Contact HoursSusan Appling, PT, DPT, PhD, OCS

Using the Diagnosis and Treatment of Movement System ImpairmentClassification to Optimize Movement inImproving the Human Experience10:00am to 12:00pm2 contact hoursMyra Meekins, PT, DPT, OCS, FAAOMPT

Saturday Lunch Hour: "PT Practice Hot Topics" with a Panel of PTs:12:00pm to12:45pmPat Flemming, PTModerator of the Forum

Scott Newton, PT, DPT, OCS, CWS & Susan Appling, PT, DPT, PhD, OCS (both from West)

Jason Richardson, PT, DPT, OCS (from Middle)

David Harris, PTA, BS, CLTReimbursement Chair (from Chattanooga)

Baron Johnson, PT (from Knoxville) Alan Meade, PT, ScDPT, MPT (from Tri-Cities)

Chapter Business Meeting12:45pm to 1:30pm

Delegates Meeting1:45pm to 2:45pm

Dry Needling1:45pm to 5:30pm3.75 Contact HoursJim Hamrick , PT andKen McMahon, PT, DPT, CMTPT

The Role of the Physical Therapist inreducing re-hospitalizations of thechronically ill and elderly patients3:00pm to 5:00pm2 Contact HoursLinda Bloodworth, PT, MS, GCS

Jurisprudence 1:45pm to 3:45pm 2 Contact HoursMary Pat Jobes, PT

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Anatomy for LE (20 people only)8:00am to 5:00pm with 1hr break for lunchWill be held at UTHSC7.5 Contact HoursRick Kasser, PT, PhD

TOPICStudents will dissect the whole LowerExtremity identifying muscles, nerves andarteries along the way. Special attention willbe placed on the hip, knee and ankle joints.

INSTRUCTORRick Kasser, PT, PhDAssociate Professor in the Physical TherapyDepartment and an Adjunct Professor in theDepartment of Neurobiology. PhD in Anatomy Kansas University.MS in Physiology Southern Illinois University.BS in Physiology Southern Illinois University.BS in Physical Therapy University ofTennessee.

Eclectic Approach to Manual Therapy8:00am to 12:00pm 3.75 Contact HoursMark Temme , PT, OCS

TOPICA hands on course with instruction in manualtherapy techniques, including grade 5, whichcan be utilized immediately in the clinic toimprove clinical outcomes for patients. Theemphasis is on instruction in manualtechniques that are used routinely in dailypractice and are integrated with the currentbest evidence.

INSTRUCTORCertified orthopedic specialist with 20 yearsexperience in outpatient orthopedicsprimarily managing patients with pain ofspinal origin. Mark originally trained at the

University of South Australia in the Maitlandapproach and subsequently completedcertification in the McKenzie and Mulliganapproach to manual therapy as well asextensive training in the osteopathicapproach to manual therapy. AdditionallyMark is a guest Lecturer at the UT PhysicalTherapy Program, Memphis.

Torticollis: diagnosis, treatment and Evidence Based Practice 8:00am to 12:00pm3.75 Contact HoursJodi Jennings, PT, DPT, PCS, Bertie Gatlin, PT, PCS, and Dr. David Spence

INSTRUCTORSJodi Jennings, PT, DPT, PCS has devoted herpractice to pediatric care for over 10 years.Jodie graduated from UT-Health ScienceCenter in 2002 with a Master’s of PhysicalTherapy. In 2007, she earned her Doctorateof Physical Therapy from UTHSC. In 2005,Jodie became certified by the AmericanBoard of Physical Therapy Specialities as aPediatric Clinical Specialist. Jodie is amember of the APTA, pediatric section of theAPTA, and the TPTA. Jodie currently worksat Baptist Pediatric Rehabilitation inGermantown, TN.

Bertie Gatlin, PT, PCS has been a practicingphysical therapist for 24 years. Her career hasfocused in the area of pediatric PT with anemphasis on the NICU and early childhooddevelopment. Bertie graduated from Universityof Memphis with B.S. in Special Education in1985 and from UT-Health Science Center in1989 with a B. S. in Physical Therapy. She iscurrently Assistant Professor at UTHSCDepartment of Physical Therapy and instructsPediatrics in PT and Neurological Disorders I.

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Courses

She is a candidate for the Doctorate of Sciencein Physical Therapy Degree from UTHSC.Bertie is a Pediatric Certified Specialist by theAmerican Board of Physical TherapySpecialities. She is a member of the APTA,serves as West Tennessee District Chair for theTPTA, Nominating Chair for West TennesseeTPTA, Tennessee State Representative forPediatric Section of the APTA and Vice Chairfor the NICU SIG of the Pediatric Section. Shecontinues to practice with MethodistHealthcare Germantown NICU and UniversityTherapists pediatric out patient clinic.

Determining Spine ExercisePrescription: PTA Decision Criteria(A course strictly for PTAs only) 7:30am to 12:00pm 3 hours lecture and 1 hour lab4 contact hoursBaron Johnson, PT

TOPICThis course is designed to teach the PTA newresearch regarding spine dysfunction,published classifications of Lumbar andCervical Dysfunctions, and criteria todeveloping an innovated exercise approach.The course will challenge the inexperiencedand experienced PTA clinician with demandingexercise routines using evidence basedinformation, cutting edge equipment anddynamic techniques to bring about recovery.

INSTRUCTORBaron is a 1979 graduate of the University ofPittsburgh, School of Health RelatedProfessions, in Physical Therapy. He ispublished in the areas of Orthopedic SpineCare and Industrial Physical Therapy. Baronhas provided industries across the Eastern andMidwest United States with solutions toprevention of Industrial and Spine injuries thepast 30 years. He has lectured extensively todifferent industries on establishing an In houseErgonomic Program, and to other Therapistson establishing a clinical spine rehabilitationprogram. He is a member of the American

Physical Therapy Association, has served onthe BOD for the Tennessee Physical TherapyAssociation the past 17 years and currentlyserves as Chapter Treasurer. Baron is a pastmember of the North American Spine Societyand Human Factor and Ergonomic Society.Baron’s daily clinical practice focuses on spinecare and rehabilitation.

Management of Severe Joint Diseaseand Chronic Illness: Lessons from theBleeding Disorder Population8:30am to 10:30am2 Contact HoursRuth Mulvany, PT, MS, DPT and Janet Tuller, RN, MPH

TOPIC Physical therapy and nursing strategies forassessment , intervention, research, andmanagement of complex musculoskeketalconditions and co-existing illness in thebleeding disorders population.

INSTRUCTORSRuth Mulvany is an associate professor at the University of Tennessee Health ScienceCenter, Department of Physical Therapy inMemphis, Tennessee. Through her facultypractice, she has 27 years of experiencecaring for people with rheumatic/connectivetissue disorders including scleroderma,rheumatoid arthritis, and Ehler’s Danlos. Her primary focus has been the bleedingdisorders population who have severe jointdisease and, in some cases, HIV/AIDS,hepatitis, and other co-morbidities. She hasauthored professional publications andjournal articles and lectures nationally andinternationally on these subjects.

Jan Tuller served as clinic nurse coordinator ofthe Hemophilia Treatment Centers in Knoxvilleand Memphis, Tennessee. For over 30 yearsshe managed adults and children with severedisorders and was on the forefront of care inthe HIV/AIDS and hepatitis outbreaks in thispopulation. She is a certified nurse specialist in

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management of cancer and AIDS. She receivednational recognition as The Outstanding Nurseof the Year from the National HemophiliaFoundation. In addition to vast clinical skills,she has been actively involved in research,publications and national scientificpresentations.

Deep Brain Stimulators & Parkinsons Disease10:00am to 12:00pm 2 Contact HoursEllen Evans Markwell, PT and Dr. Karl Sillay

TOPICPractical approach of evaluating and treatingthe patient with PD

INSTRUCTORSEllen Evans Markwell, PTI am Senior PT supervising outpatient adultrehab at Methodist LeBonheur HospitalGermantown. I have been working inoutpatient PT for the last 22 years. Myprimary focus is orthopedics and neurology,specifically focusing on adults diagnosedwith movement disorders, specificallyParkinson’s Disease. Dr. Karl Sillay obtained his Bachelor ofElectrical Engineering Degree from theGeorgia Institute of Technology in 1995. Hereceived his Medical Degree in 1999 from theMedical College of Georgia. He completedhis internship at Vanderbilt University, andalso his Neurosurgical Residency, which hecompleted in 2006. In 2007, Dr. Sillaycompleted a Fellowship in Epilepsy andFunctional Neurosurgery at the University ofCalifornia at San Francisco. He is certified bythe American Board of Neurological Surgery.

Evidence Based Management of Hip and Knee OA1:00pm to 5:00pm3.75 Contact HoursAdam Risinger andCraig O’Neil

Vestibular Rehab1:00pm to 3:00pm 2 Contact HoursMelanie Morton, PT, NCS and Teresa Murphy, PT

INSTRUCTORSTeresa graduated from the UT Center forHealth Sciences with a BS in PT in MemphisTN in December 1976 and has been workingin clinical practice for Baptist MemorialHealthcare System for 36 years. Over thepast 15 years her clinical focus has been onneurological dizziness and balance issues.She achieved her certification in VestibularRehabilitation from the APTA course atEmory University in Atlanta, GA in 2010 andhas developed the Vestibular Rehab / BalanceOutpatient Program at Baptist Rehab.Germantown.

Melanie Morton, PT, NCS has over 13 years ofexperience in the area of neurologicalphysical therapy. She graduated with a BS inPhysical Therapy from the University ofTennessee, Memphis in 1999. She achievedher board – certification as a NeurologicCertified Specialist in 2006. She is a Memberof the APTA, APTA Neuro Section and theTPTA. She currently works at BaptistRehabilitation in Germantown in outpatient asa neurological physical therapist.

Healthcare Reform, Healthcare Policy,Payment Policy, ACOs, SharedSavings: Where does the PTprofession fit in? 8:00am to 12:00pm 3.75 Contact HoursAlan Meade PT, ScDPT, MPT and Jason Richardson, PT, DPT, OCS, COMT

INSTRUCTORJason Richardson is Sr. Vice-President ofClinical Operations for Results PhysiotherapyCenters were he oversees the clinicaloperations and strategic positioning theorganization. Results Physiotherapy operates

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45 private practice clinics in Tennessee,Alabama, Mississippi, Kentucky, NorthCarolina and Georgia. Jason earned hisMaster’s degree in Physical Therapy in 1998,and completed his Doctoral studies in 2004from Shenandoah University.

Jason is active politically with eliminatingstate and federal regulations that negativelyobstruct patient access and limit the practiceof licensed physical therapists. Jason alsopursues top of license collaborations amonghealth providers in innovative health deliverymodels to improve population health.

Jason is served 2 terms as Secretary on theexecutive board of the Tennessee PhysicalTherapy Association (TPTA), 1 term on theReferral for Profit Committee with theAmerican Physical Therapy Association(APTA), and served several consulting roleswith insurance payors and private practices.Most recently Jason serves on the APTA’sPhysical Therapy Classification and PaymentSystem Task Force and the Private PracticeSections Payment Policy Committee. Jasonis very passionate about eliminatingobstacles that preclude patient access andfair payment to quality therapy services.

Pharmacology for the PhysicalTherapist: From Acute CareTransitioning to Outpatient8:00am to 10:00am2 Contact HoursDavid Shoop, PharmD and Tara Parrish, ParmD

Ethics9:00am to 11:00am2 contact hoursSusan Appling, PT, DPT, PhD, OCS

Using the Diagnosis and Treatment of Movement System Impairment Classification to Optimize Movementin Improving the Human Experience10:00am to 12:00pm2 contact hoursMyra Meekins, PT, DPT, OCS, FAAOMPT

Saturday Lunch Hour: "PT PracticeHot Topics" with a Panel of PTs:12:00pm to 12:45pmPat Flemming, PT Moderator of the Forum:

Scott Newton, PT, DPT, OCS, CWS & Susan Appling, PT, DPT, PhD, OCS (both from West)Jason Richardson, PT, DPT, OCS (from Middle)

David Harris, PTA, BS, CLT--ReimbursementChair (from Chattanooga)

Baron Johnson, PT (from Knoxville)

Alan Meade, PT, ScDPT, MPT (from Tri-Cities).

Dry Needling1:45pm to 5:30pm3.75 Contact HoursJim Hamrick , PT andKen McMahon, PT, DPT, CMTPT

INSTRUCTORSKen has been a clinical director at Rehab Etc.Physical Therapy in Bartlett, TN since 1994.He graduated from the University ofMemphis in 1996 and received a degree inBachelor of Science in Molecular Biology andalso graduated from Belmont University in2000. Over the past 12 years, he hasattended many physical therapy andmanipulation courses and seminars focusingon the spine, neck, and upper body. Ken wasalso an instructor for the UT MemphisPhysical Therapy and Belmont UniversityPhysical Therapy.

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Jim has been in out-patient Physical Therapysince 1988. He began his private practice, Rehabetc, in Memphis TN 1993. He developed a focuson Myofascial pain and dysfunction. Jimreceived his certification in Manual Myofascialpain in 2007, and subsequent IntramuscularDeep Dry Needling certification from Janet G.Travell, Myopain Seminars in 2011. He enjoysoutdoors camping and traveling. He has beenmarried to Terri Hambrick 30 years and has 2adult children.

The Role of the Physical Therapist inreducing re-hospitalizations of thechronically ill and elderly patients3:00pm to 5:00pm2 contact hoursLinda Bloodworth, PT, MS, GCS

TOPICA disproportionate amount of health caredollars are spent on older adults andhospitalizations, specifically forhospitalizations related to chronic disease. In this session we will discuss factors relatedto older adults’ need for hospitalizations andinability to successfully “age in place.” Wewill review the literature to determine whatfactors can potentially reduce hospitalizationsand what role physical therapy may play inthat effort.

INSTRUCTORLinda Bloodworth, MS, PT GCS graduated in1982 from Samford University and went on toobtain an MS in Physical Therapy from theUniversity of Alabama at Birmingham in 1985.She is currently Regional Rehab Consultant(for Physical, Occupational and SpeechTherapy Services) for National HealthCareCorporation’s Central Tennessee Region,consisting of twelve Skilled Nursing Facilities,seven Homecare Offices and numeroustherapy contract sites. In addition to herconsultant responsibilities, Linda is programdirector of NHC’s APTA credentialed GeriatricResidency Program.

Jurisprudence 1:45pm to 3:45pm 2 contact hoursMary Pat Jobes, PT

TOPICThis course covers legal issues in physicaltherapy and the Tennessee Practice Act andRules Governing the Practicing of PhysicalTherapy.

INSTRUCTORMs. Jobes received her BS degree in physicaltherapy from the University of Tennessee–Memphis and a Master’s degree in physicaltherapy from NYU. She served as Chair ofMemphis District of the Tennessee PhysicalTherapy Association and the BOD for TPTAfor 11 years, President of the Acute CareSection of the American Physical TherapyAssociation for two terms and on the AcuteCare section BOD for a total of 9 years. She isa site visitor for the Commission onAccreditation in Physical Therapy Education.Ms. Jobes served as the APTA External Liaisonto the Joint Commissions PTAC for Hospitalsfor 8 years and served as a Trustee of the PT-PAC. Ms. Jobes is the Manager of PhysicalTherapy at Haywood Park CommunityHospital. She has taught Ethics andJurisprudence for TPTA for the last 10 years.

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Conference InformationMake your reservations by mailing or faxing (615-297-5852)

the attached registration form to the TPTA Office.

For more information, contact the TPTA office at [email protected] or 615-269-5312.

Registrations may also be downloaded from the TPTA website www.tptatn.org.

Course certificates will be given out at the end of each course. If you do not pick up your certificate at the end of the course, you will

not receive full credit for the course without proof of completing the course.

CancellationCancellations will be accepted until September 25, 2013.

A refund minus $25 of registration monies is honored through September 25th. No refund will be given after September 26th.

_______________________________________________

LocationPEABODY HOTEL10 Century BoulevardMemphis, Tennessee, 37214There are a number of rooms being held

at the rate of $149 – they will be held untilAugust 31, 2013 and based upon availabilityafter that date. Just let them know you are withthe Tennessee Physical Therapy Association.

Call 1-800-Peabody to make your reservation._______________________________________________

You can also go to TPTATN.org and click on Meetings/Events TPTA Fall Meetingand there will be a direct link to register.

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COURSES & PRICES (Please check the courses you are interested in taking)

� Anatomy for LE (20 people only)8:00am to 5:00pm with 1hr break for lunchWill be held at UTHSC7.5 Contact HoursRick Kasser, PT, PhD

� Torticollis: Diagnosis, Treatment and Evidence Based Practice 8:00am to 12:00pm3.75 Contact HoursJodi Jennings, PT, DPT, PCS, Bertie Gatlin, PT, PCS, and Dr. David Spence

� Determining Spine Exercise Prescription: PTA Decision Criteria(A course strictly for PTAs only) 7:30am to 12:00pm 4 contact hoursBaron Johnson, PT

� Management of Severe Joint Disease and Chronic Illness: Lessons from the BleedingDisorder Population8:30am to 10:30am 2 Contact HoursRuth Mulvany, PT, MS, DPT and Janet Tuller, RN, MPH

� Deep Brain Stimulators & Parkinsons Disease10:00am to 12:00pm 2 Contact HoursEllen Markwell, PT and Dr. Sillay

� Eclectic Approach to Manual Therapy8:00am to 12:00pm 3.75 Contact HoursMark Temme , PT, OCS

� Evidence Based Management of Hip and Knee OA1:00pm to 5:00pm3.75 Contact HoursAdam Risinger, PT, OCS, Cert. MDT andCraig O’Neil, PT, DMT, OCS

� Vestibular Rehab1:00pm to 3:00pm 2 Contact HoursMelanie Morton, PT, NCS and Teresa Murphy, PT

� Healthcare Reform, Healthcare Policy, Payment Policy, ACOs, Shared Savings: Where does the PT profession fit in? 8:00am to 12:00pm 3.75 Contact HoursAlan Meade PT, ScDPT, MPT and Jason Richardson, PT, DPT, OCS

� Pharmacology for the Physical Therapist: From Acute Care Transitioning to Outpatient8:00am to 10:00am2 Contact HoursDavid Shoop, PharmD and Tara Parrish, ParmD

� Ethics 9:00am to 11:00am2 Contact HoursSusan Appling, PT, DPT, PhD, OCS

� Using the Diagnosis and Treatment of Movement System Impairment Classificationto Optimize Movement in Improving the Human Experience10:00am to 12:00pm2 contact hoursMyra Meekins, PT, DPT, OCS, FAAOMPT

� Dry Needling1:45pm to 5:30pm 3.75 Contact HoursJim Hamrick , PT andKen McMahon, PT, DPT, CMTPT

� The Role of the Physical Therapist in reducing re-hospitalizations of the chronically ill and elderly patients.3:00pm to 5:00pm2 Contact HoursLinda Bloodworth, PT, MS, GCS

� Jurisprudence 1:45pm to 3:45pm2 Contact HoursMary Pat Jobes, PT

PT Member . . . . . . . . .$225 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PT Nonmember . . . . . .$368 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA Member . . . . . . . . .$120 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA NonMember . . . . .$177 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

PT Member . . . . . . . . . .$112 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PT NonMember . . . . . .$184 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA Member . . . . . . . . . .$60 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA NonMember . . . . . .$94 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Student . . . . . . . . . . . . . . .$20 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

PTA Member . . . . . . . . . .$60 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA NonMember . . . . . .$94 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

PT Member . . . . . . . . . . .$60 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PT NonMember . . . . . . .$98 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA Member . . . . . . . . . .$32 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA NonMember . . . . . .$50 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Student . . . . . . . . . . . . . . .$10 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

PT Member . . . . . . . . . . .$60 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PT NonMember . . . . . . .$98 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA Member . . . . . . . . . .$32 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA NonMember . . . . . .$50 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Student . . . . . . . . . . . . . . .$10 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _



PT Member . . . . . . . . . .$60 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PT NonMember . . . . . .$98 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA Member . . . . . . . . . .$32 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA NonMember . . . . . .$50 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Student . . . . . . . . . . . . . . .$10 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _


PT Member . . . . . . . . . .$60 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PT NonMember . . . . . . .$98 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA Member . . . . . . . . .$32 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PTA NonMember . . . . .$50 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Student . . . . . . . . . . . . . .$10 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _






BOX LUNCH: (Included for Friday and Saturday) Please check below or no lunch will be provided.

Friday, September 27th � YES � NOSaturday, September 28th � YES � NO

� Social Registration (Not Attending Classes)Includes: Breakfast, Lunch, Exhibits and Chapter Business

Meeting Saturday 12:45pm-1:30pm $25_______________

� TPT-PAC Reception and UTHSC Alumni and Friends Reception – 5:30pm to 7:00pmPlease check box if you plan to attend.

Total Paid:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $___________________

To register, detach this completed registration form and send it along with payment to:

Tennessee Physical Therapy Association4205 Hillsboro Road, Suite 317Nashville, TN 37215

for more information or to register by fax:Phone: 615-269-5312 • Fax: 615-297-5852

download registration form at:tptatn.org

REGISTRATION (please type or print neatly)

Name: _____________________________________________________________________________________________________________________________

Company: _______________________________________________________________________________________________________________________

Address: __________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________________________

City: ___________________________________________________________ State: ______________ Zip: _______________________________

Phone: __(________________)_____________________________________________ Fax: __(________________)_______________________________________________

Email: ______________________________________________________________________________________________________________________________

Check One:

� PT Member � PT Nonmember � PTA Member � PTA Nonmember � Student Member � Student Nonmember

APTA Member #: __________________________________________________________________________________________________________

Payment Method:

� Check enclosed (Payable to TPTA) � VISA � MC � AMEX

Account #: __________________________________________________________________ Exp. Date: ___________________/_______________/___________Name of Cardholder: _____________________________________________________________________________________________________

Billing Address of Cardholder: _____________________________________________________________________________________

____________________________________________________________________________________________________________________Total Paid: $ ______________________________

Disclosure: By registering for this meeting the attendee acknowledges and provides the TPTApermission to do random video taping and photography for marketing and promotional purposes.

All meetings will be held at the Peabody Hotel

peabody hotel - c.ymcdn.comc.ymcdn.com/sites/ · peabody hotel memphis, tennessee. schedule ......

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