Imaging Special Interest Group of the Academy of Orthopaedic Physical Therapy

Combined Sections Meeting Scholarship Application Form

Name*

Email*

Phone*

APTA Membership Number*

Presenter Information

(If different than the person above)

Name

Phone

APTA Membership Number

Abstract Title*

Abstract Number

Abstract Coauthors

Provide a short statement on how this work impacts or expands the use of diagnostic and/or procedural imaging in Physical Therapy practice, research or health care systems (Maximum 200 words)*

Attachment File

By submitting this application, I certify that this work adheres to the ethical standards of the Physical Therapy Journal. I certify that this work has not been previously presented at a national or international conference, nor published or accepted for publication.

* Requred Fields

For information please contact Murray Maitland PT, PhD Imaging SIG Scholarship Committee Chair: mmaitlan@u.washington.edu