Kelly Campbell, Bickle 130 Dunn Avenue ext. 2141

Size: px
Start display at page:

Download "Kelly Campbell, Bickle 130 Dunn Avenue 416-597-3422 ext. 2141"

Transcription

1 Toronto Rehab has a variety of interesting co-op opportunities that give you the opportunity to: Eplore or confirm career choices Acquire new skills and build your resume Meet new people and become part of a team A Co-op placement at Toronto Rehab is truly rewarding and there are many ways in which you can contribute your time. Co-op students help patients and staff with a wide variety of placements and projects across all of our five locations in Toronto. We work with those: who have had a heart attack or major heart surgery; with comple medical conditions such as Alzheimer disease, cerebral palsy, multiple sclerosis and Parkinson s disease; who have severe and comple illnesses; who have had joint replacement surgery, multiple fractures, osteoporosis and cancer; who have eperienced a stroke or brain injury; and with a spinal cord injury or disease. As a fully affiliated teaching hospital of the University of Toronto, Co-op students become a part of a health care team committed to advancing rehabilitation and enhancing quality of life. Toronto Rehab needs people who share in our vision. Cooperative Education at Toronto Rehab Cooperative Education student placements are coordinated by Volunteer Resources at all Toronto Rehab locations. To facilitate placements, teachers should contact the school board's central placement recruiter directly. School board central recruiters will then contact the Coordinator, Volunteer Resources at the Toronto Rehab location of their choice to arrange placements. For further information about Toronto Rehab, and our application process, please visit our website at Volunteer Resources Consultants: Kelly Campbell, Bickle 130 Dunn Avenue et Kimberley Riley, Lyndhurst 520 Sutherland Drive & Rumsey Centres 345/347 Rumsey Road et Lynda Watson, Hillcrest Centre 47 Austin Terrace & University Centre 550 University Avenue et (turn over for a list of placements)

2 COOPERATIVE EDUCATION STUDENT PLACEMENTS AT TORONTO REHAB Coop Placements (Please note: some placements may not always be available) Bickle Centre 130 Dunn Avenue (near Dufferin & King Streets) University Centre 550 University Avenue (near University Avenue and Dundas Street) Hillcrest Centre 47 Austin Terrace (near Bathurst Street and Davenport Road) Administration/Medical Depts. Art Program Chaplaincy Child Care Centre Dentistry Gift Shop Nursing Unit Occupational Therapy - clerical support only Social Programs for Patients Socialization Speech Language Pathology Unit Support (encompasses socialization, recreation, meal support, patient grooming, family support, admin. support, etc.) November 2010 Lyndhurst/Rumsey Centres 520 Sutherland Drive (near Bayview and Eglinton Avenues)

3 COOPERATIVE EDUCATION HEALTH CARE FACILITY PLACEMENT APPLICATION FORM Please check appropriate Board: York Region District School Board York Catholic District School Board Ecole secondaire catholique Renaissance Teacher Information: For the three hospitals on List A: North York General Hospital/The Scarborough Hospital/York Central Hospital Forward to: Brenda Pembleton, Placement Facilitator, Centre for Leadership & Learning, E.C. Newmarket et FAX: For Hospitals on List B: **Send directly to hospital after initially contacting by phone. Where hospitals are listed on both List A&B, contact those hospitals directly. SECTION A TO BE COMPLETED BY STUDENT All parts of this application form must be completed neatly, accurately and legibly. Incomplete applications will NOT be considered. Please Print Student s Name Student s Home Phone School Name School Phone Co-op Teacher/Monitor Emergency Contact Et. Career Goals Phone Languages Spoken Special Accommodations Needed: Yes No Specialist High Skills Major candidate Yes No HEALTH CARE FACILITY APPLYING TO: Placement Requested: Students should choose from the list of placements available at the hospital to which they are applying. Choice # 1 Choice # 2 1

4 LEVEL OF STUDY (pertinent school subjects: e.g. Grade 11, Advanced Biology) COURSES COMPLETED: COURSE PRESENTLY TAKING: Number of credits completed by start of placement: SEMESTER 1 (Sept.-Jan.) SEMESTER 2 (Feb.-June) Full Year STUDENT WORK SCHEDULE Full Day (4 days per week) Please circle days: M T W T F Half Days (4 days per week) a.m. p.m. Please circle days: M T W T F Half Days (every other day) a.m. p.m. Please circle days: M T W T F START DATE END DATE START TIME FINISH TIME IN-SCHOOL DAY FOR CO-OP PROGRAM: SECTION B TO BE COMPLETED BY STUDENT A. On a separate sheet of paper, answer the following questions: 1) Why have you requested a placement in a health care facility? 2) How will this placement help you with your career choice? 3) What can you contribute as a Co-op student in this placement? (Discuss your volunteer work, personal strengths, and prior relevant eperience.) 4) What research have you done to eplore this career pathway (e.g. personal interviews, internet, career centre, guidance counselors)? 5) Are there any physical or medical conditions that would restrict your activities at the placement? Yes No If YES, please eplain. B. Attach a current resume. (for assistance visit website: C. Attach 2 references 1) teacher who knows you well (i.e. guidance, subject teacher, administrator. ) 2) one other person of your choice (must not be a peer or family member) STUDENT S SIGNATURE 2

5 SECTION C REFERENCE: TO BE COMPLETED BY A TEACHER WHO KNOWS YOU WELL (i.e. Subject Teacher, Guidance Teacher, Administrator) Student s Name: Please rank the student on a scale of one (1) to four (4), with FOUR being the highest ranking. Dependability RANKING Ability to get along with others Ability to plan and initiate own learning Please indicate below why you think this student should be placed in this Health Care Co-op placement (taking into consideration his / her success in your subject area). Teacher s Name: (Please Print) Signature: Title: Teacher s Phone Number: Date: FREEDOM OF INFORMATION This information is collected under the authority of the Education Act and in compliance with Section 14, Section 32 and Subsection 29 (2) of the Municipal Freedom of Information and Protection of Privacy Act and will be used for the ongoing administration of appropriate Cooperative Education placements. 3

6 SECTION D COMPLETED BY A PERSON OF YOUR CHOICE WHO KNOWS YOU WELL (This should not be a peer or family member) Student s Name: Please rank the student on a scale of one (1) to four (4), with FOUR being the highest ranking. RANKING Dependability Ability to get along with others Ability to plan and initiate own learning Please indicate below why you think this student should be placed in this Health Care Co-op placement (taking into consideration his/ her success in your subject area). Name: (Please Print) Signature: Title: Phone Number: Date: FREEDOM OF INFORMATION This information is collected under the authority of the Education Act and in compliance with Section 14, Section 32 and Subsection 29 (2) of the Municipal Freedom of Information and Protection of Privacy Act and will be used for the ongoing administration of appropriate Cooperative Education placements. Revised April

7 MANTOUX 2 STEP T.B. TEST (TUBERCULOSIS) Any student planning to participate in a Cooperative Education placement in a Health Care Facility must have this T.B. Test. The test is required by the Public Hospitals Act. Please Print NAME OF STUDENT SCHOOL ALL STUDENTS MUST BE TESTED PRIOR TO START OF PLACEMENT. Please take this form to your doctor for completion. office stamp this form. Please have the doctor s STEP 1 Date of Injection Date Read Result STEP 2 Date of Injection Date Read Result DATE: Doctor s Signature & Stamp

Complex Outpatient. Injury. Rehab. Integrated, evidence-based rehab that supports a timely return to home, life, work or school

Complex Outpatient. Injury. Rehab. Integrated, evidence-based rehab that supports a timely return to home, life, work or school Complex Outpatient Injury Rehab Integrated, evidence-based rehab that supports a timely return to home, life, work or school Toronto Rehabilitation Institute At Toronto Rehab, our goal is to advance rehabilitation

More information

Cardiovascular Prevention and Rehabilitation Program

Cardiovascular Prevention and Rehabilitation Program Cardiovascular Prevention and Rehabilitation Program Leading the way to a healthier heart For people who have had a heart attack, heart surgery or other cardiac event, or for those who have two or more

More information

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, post-polio syndrome, rheumatoid arthritis, lupus

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, post-polio syndrome, rheumatoid arthritis, lupus TIRR Memorial Hermann is a nationally recognized rehabilitation hospital that returns lives interrupted by neurological illness, trauma or other debilitating conditions back to independence. Some of the

More information

DRIVER REHABILITATION OVERVIEW

DRIVER REHABILITATION OVERVIEW DRIVER REHABILITATION OVERVIEW What is included in a Driving Evaluation? The purpose of the evaluation is to determine if the individual s medical condition, medications, functional limitations and/ or

More information

Critical Illness Insurance. What is Critical Illness Insurance

Critical Illness Insurance. What is Critical Illness Insurance Critical Illness Insurance What is Critical Illness Insurance Whereas life insurance has been readily available for literally hundreds of years, critical illness insurance is a relatively recent development.

More information

UW Hospital and Clinics (UWHC) Acute Rehabilitation served 358 individuals between January 2011 and December 2011.

UW Hospital and Clinics (UWHC) Acute Rehabilitation served 358 individuals between January 2011 and December 2011. Program Facts Program Facts The Program provides injury/illness-specific programs that offer patients care needed to regain the abilities to perform daily tasks, restore basic life skills, reclaim cognitive

More information

Rehabilitation Where You Recover. Inpatient Rehabilitation Services at Albany Medical Center

Rehabilitation Where You Recover. Inpatient Rehabilitation Services at Albany Medical Center Rehabilitation Where You Recover Inpatient Rehabilitation Services at Albany Medical Center You're Here and So Are We As the region s only academic medical center, Albany Medical Center offers a number

More information

SAM KARAS ACUTE REHABILITATION CENTER

SAM KARAS ACUTE REHABILITATION CENTER SAM KARAS ACUTE REHABILITATION CENTER 1 MEDICAL CARE Sam Karas Acute Rehabilitation The Sam Karas Acute Rehabilitation Center is a comprehensive and interdisciplinary inpatient unit. Medical care is directed

More information

Name: Birthdate: Age: Address: City, State, ZIP: Preferred Phone # (Home)(Cell)(Work): Marital Status: M S W D

Name: Birthdate: Age: Address: City, State, ZIP: Preferred Phone # (Home)(Cell)(Work): Marital Status: M S W D Be Fit Physical Therapy & Pilates, LTD Patient Registration Form Date: Name: Birthdate: Age: Address: City, State, ZIP: Preferred Phone # (Home)(Cell)(Work): Marital Status: M S W D Secondary Phone# (Home)(Cell)(Work):

More information

Key Terms. Chapter 38. Disability, p. 640. Rehabilitation, p. 640. Rehab (cont) p. 640. Rehab. (cont), p. 640

Key Terms. Chapter 38. Disability, p. 640. Rehabilitation, p. 640. Rehab (cont) p. 640. Rehab. (cont), p. 640 Key Terms Chapter 38 Rehabilitation & Restorative Care Activities of daily living (ADL s) Disability Rehabilitation Restorative aide Restorative nursing care Disability, p. 640 Is any loss, absent, or

More information

Profile: Kessler Patients

Profile: Kessler Patients Profile: Kessler Patients 65 Breakthrough Years Kessler Institute has pioneered the course of medical rehabilitation since 1948. Today, as the nation s largest single rehabilitation hospital, we continue

More information

Spaulding Rehabilitation Hospital Boston 2014 Patient and Family Advisory Council Annual Report

Spaulding Rehabilitation Hospital Boston 2014 Patient and Family Advisory Council Annual Report Spaulding Rehabilitation Hospital Boston 2014 Patient and Family Advisory Council Annual Report Hospital Name: Spaulding Rehabilitation Hospital Boston Date of Report: October 1, 2014 Year Covered by Report:

More information

REHABILITATION. begins right here

REHABILITATION. begins right here REHABILITATION begins right here Select Rehabilitation Hospital of Denton offers you a new direction in medical rehabilitation. Our 44-bed, state-of-the-science hospital offers unparalleled treatment to

More information

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, postpolio syndrome, rheumatoid arthritis, lupus

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, postpolio syndrome, rheumatoid arthritis, lupus TIRR Memorial Hermann is a nationally recognized rehabilitation hospital that returns lives interrupted by neurological illness, trauma or other debilitating conditions back to independence. Some of the

More information

National Stroke Association s Guide to Choosing Stroke Rehabilitation Services

National Stroke Association s Guide to Choosing Stroke Rehabilitation Services National Stroke Association s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you: Re-learn basic skills

More information

Sun Critical Illness Insurance

Sun Critical Illness Insurance Sun Critical Illness Insurance PRODUCT FEATURE SHEET CRITICAL ILLNESS INSURANCE gives you a lump sum payment if you are diagnosed with and survive an illness covered by your plan. Having this extra measure

More information

Patient Information Guide. Getting you Back to Better. 859.426.2400 www.vrhgateway.com

Patient Information Guide. Getting you Back to Better. 859.426.2400 www.vrhgateway.com Patient Information Guide Getting you Back to Better 859.426.2400 www.vrhgateway.com The Gateway Difference Gateway Rehabilitation Hospital provides expert care to help patients get back to better after

More information

Rehabilitation. Day Programs

Rehabilitation. Day Programs Rehabilitation Day Programs Healthe Care is the hospital division of Healthe. As the largest privately owned network of private hospitals in Australia, we take pride in delivering premium care to our valued

More information

Critical Illness Insurance. Second Chance for Children 30 days to 17 years

Critical Illness Insurance. Second Chance for Children 30 days to 17 years Critical Illness Insurance Second Chance for Children 30 days to 17 years Second Chance for Children Protect your children in case of critical illness so you can afford to stay by their bedside If one

More information

Please complete the application documents and email them to the specified address. We look forward to adding you to our valued volunteer team!

Please complete the application documents and email them to the specified address. We look forward to adding you to our valued volunteer team! Dear Prospective Volunteer: We are excited that you have expressed an interest in volunteering at Doctors Hospital at White Rock Lake. As a volunteer, you will be providing services and support to patients,

More information

Volunteer Application

Volunteer Application Thank you for your interest in volunteer opportunities here at Magee Rehabilitation Hospital. To apply for volunteer placement, you will need to commit to volunteering a minimum of 100 hours and: 1) Complete

More information

Critical Illness Insurance. Second Chance for Children 30 days to 17 years

Critical Illness Insurance. Second Chance for Children 30 days to 17 years Critical Illness Insurance Second Chance for Children 30 days to 17 years Second Chance for Children Protect your children in case of critical illness so you can afford to stay by their bedside If one

More information

2015 FRA Education Scholarship Program LA FRA Scholarship Deadline: Postmarked No Later Than April 15, 2015

2015 FRA Education Scholarship Program LA FRA Scholarship Deadline: Postmarked No Later Than April 15, 2015 RULES 1. You may apply for LA FRA Member Scholarships if the applicant or sponsor is a member in good standing of the LA FRA or FRA, currently or at time of death. The applicant must be a LA FRA or FRA

More information

REHABILITATION SERVICES

REHABILITATION SERVICES REHABILITATION SERVICES Table of Contents GENERAL... 2 TERMS AND ABBREVIATIONS... 2 PRIOR AUTHORIZATION REQUIREMENTS FOR MEDICAID REIMBURSEMENT OF INPATIENT REHABILITATION SERVICES (Updated 4/1/11)...

More information

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, postpolio syndrome, rheumatoid arthritis, lupus

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, postpolio syndrome, rheumatoid arthritis, lupus TIRR Memorial Hermann is a nationally recognized rehabilitation hospital that returns lives interrupted by neurological illness, trauma or other debilitating conditions back to independence. Some of the

More information

EMU Psychology Clinic 611 W. Cross Street Ypsilanti, MI 48197 (734) 487-4987. Client Application Child

EMU Psychology Clinic 611 W. Cross Street Ypsilanti, MI 48197 (734) 487-4987. Client Application Child A. Identification 1. Child s name EMU Psychology Clinic 611 W. Cross Street Ypsilanti, MI 48197 (734) 487-4987 Client Application Child Birthdate Age Grade: Person(s) completing this form Today s date

More information

Adult Speech-Language Pathology Services in Health Care

Adult Speech-Language Pathology Services in Health Care Adult Speech-Language Pathology Services in Health Care How do speech-language pathologists (SLPs) help people? SLPs work with people who have trouble speaking listening reading writing thinking swallowing

More information

Welcome to Tri-State Rehab Services

Welcome to Tri-State Rehab Services Welcome to Tri-State Rehab Services Ashland Ironton Jackson Louisa New Boston Westmoreland Thank you for choosing our facility. To help us meet all your physical therapy needs, please fill out forms completely

More information

AA Life Insurance providing access to Best Doctors. AA Life Insurance is provided by Friends Life and Pensions Limited

AA Life Insurance providing access to Best Doctors. AA Life Insurance is provided by Friends Life and Pensions Limited AA Life Insurance is provided by Friends Life and Pensions Limited What would be the first thing you might think about if you were diagnosed with a serious illness? 2 It is very likely that the first thing

More information

Baptist Health Rehabilitation Institute. Clinical Outcomes

Baptist Health Rehabilitation Institute. Clinical Outcomes Baptist Health Rehabilitation Institute Clinical Outcomes Baptist Health Rehabilitation Institute (BHRI), located on chaplain services offer a range of individualized evaluations and the campus of Baptist

More information

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, postpolio syndrome, rheumatoid arthritis, lupus

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, postpolio syndrome, rheumatoid arthritis, lupus TIRR Memorial Hermann is a nationally recognized rehabilitation hospital that returns lives interrupted by neurological illness, trauma or other debilitating conditions back to independence. Some of the

More information

Building Futures Scholarship Application Form 2015. Thank you for your interest In the Building Futures Scholarship Program.

Building Futures Scholarship Application Form 2015. Thank you for your interest In the Building Futures Scholarship Program. Building Futures Scholarship Application Form 2015 Thank you for your interest In the Building Futures Scholarship Program. Each application form is reviewed by Canadian Natural's Building Futures Advisory

More information

For the Employees of Amarillo Independent School District. Critical Illness Insurance. A limited benefit policy

For the Employees of Amarillo Independent School District. Critical Illness Insurance. A limited benefit policy For the Employees of Amarillo Independent School District Critical Illness Insurance A limited benefit policy A critical illness isn t polite. It doesn t announce its presence before barging into your

More information

Patient Information: In Case of Emergency: Physician: Insurance:

Patient Information: In Case of Emergency: Physician: Insurance: For office use only: Start of Care: ICD-9 Codes: Patient Information: Name: Address: City: State: IL Zip: Patient of Birth: Policy Holders of Birth: of Injury or Onset of Symptoms: Home Phone: Work Phone:

More information

AA Life Insurance providing access to Best Doctors. AA Life Insurance is provided by Friends Life Limited

AA Life Insurance providing access to Best Doctors. AA Life Insurance is provided by Friends Life Limited AA Life Insurance is provided by Friends Life Limited What would be the first thing you might think about if you were diagnosed with a serious illness? It is very likely that the first thing you might

More information

Applications must be received by: March 11, 2011 Incomplete or late applications will not be considered.

Applications must be received by: March 11, 2011 Incomplete or late applications will not be considered. HISPANIC SCHOLARSHIP ENDOWMENT FUND 2011 SCHOLARSHIP APPLICATION SPONSORED BY: Ibero-American Action League, Inc. (585) 256-8900, 256-0120 fax www.iaal.org Applications must be received by: March 11, 2011

More information

RESEARCHING AND CHOOSING A SCHOOL

RESEARCHING AND CHOOSING A SCHOOL RESEARCHING AND CHOOSING A SCHOOL This section is to help you determine what school best suits your learning style and training needs. It is your responsibility to investigate all of the available courses

More information

Proudly Announces LLUMCMKTG#CH-022-09/0509/1

Proudly Announces LLUMCMKTG#CH-022-09/0509/1 Proudly Announces We are seeking professional volunteers to be counselors and co-counselors for our annual three day grief camp. The camp will address different developmental ages of children who have

More information

Rehabilitation and Choosing a Rehab Center

Rehabilitation and Choosing a Rehab Center The following excerpt has been taken from the Christopher & Dana Reeve Foundation Paralysis Resource Center website. http://www.christopherreeve.org/site/c.mtkzkgmwkwg/b.4453457/k.a4cb/overview How_to_Pick_a_Rehab.htm

More information

SCHNURMACHER CENTER FOR REHABILITATION AND NURSING

SCHNURMACHER CENTER FOR REHABILITATION AND NURSING Dear Junior Volunteer Applicant, Enclosed is an application to join the Department of Volunteers at the Schnurmacher Nursing Home. Our program is designed to allow us to adequately train and orient volunteers

More information

Symbility Health Adjudicare Group Insurance Plan Outline

Symbility Health Adjudicare Group Insurance Plan Outline Symbility Health Adjudicare Group Insurance Plan Outline 2013 Symbility Solutions Inc. Who is Eligible? All Eligible Employees under the age of 65, working a minimum average of 15 hours per week are Eligible

More information

Additional General Information regarding Personal Protection

Additional General Information regarding Personal Protection Additional General Information regarding Personal Protection Information regarding the research we used The research house we subscribe to regarding personal protection is Omnium. In a separate document

More information

NFCA/Allsup Family Caregiver Survey

NFCA/Allsup Family Caregiver Survey NFCA/Allsup Family Caregiver Survey Insight into the concerns, interests and activities of higher burden family caregivers October 2011 NFCA member/higher burden caregiver profile 2-3 Caregiver and care

More information

trilogy Universal Life Insurance For your way of life Tailor your insurance protection

trilogy Universal Life Insurance For your way of life Tailor your insurance protection trilogy Universal Life Insurance For your way of life Tailor your insurance protection For your way of life As you travel through life, you can be sure of one thing: the world you live in is constantly

More information

The Foundation Scholarship

The Foundation Scholarship established 1993 Applications are available Online www.the-ftts.org or in your High School Counseling Center Scholarship Overview Scholarship is available to any OREGON accredited College or University,

More information

Optional Group Critical Illness. Financial support at a critical time

Optional Group Critical Illness. Financial support at a critical time Optional Group Critical Illness Financial support at a critical time Medical advances have greatly increased the ability of Canadians to survive a critical illness. However, few of us are prepared for

More information

Medical Rehabilitation. Rehabilitation Unit

Medical Rehabilitation. Rehabilitation Unit Medical Rehabilitation Rehabilitation Unit Medical Rehabilitation The purpose of this handout is to give you information about University Hospital s Rehabilitation Unit (2 North or 2N). It will explain:

More information

LA OWCA Second Injury Board Knowledge Questionnaire WARNING

LA OWCA Second Injury Board Knowledge Questionnaire WARNING 1001 North 23 rd Street Post Office Box 44187 Baton Rouge, LA 70804-4187 (O) 225-342-7866 800-201-2493 (F) 225-219-5968 Bobby Jindal, Governor Curt Eysink, Executive Director Office of Workers Compensation

More information

ABILENE CAMP REHAB BUDDY COLLEGE SCHOLARSHIP APPLICATION NAME OF APPLICANT

ABILENE CAMP REHAB BUDDY COLLEGE SCHOLARSHIP APPLICATION NAME OF APPLICANT ABILENE CAMP REHAB BUDDY COLLEGE SCHOLARSHIP APPLICATION 2015 NAME OF APPLICANT ELIGIBILITY AND REQUIREMENTS To be eligible to apply for the Camp Rehab Buddy College Scholarship, an applicant must meet

More information

NURSING STUDENT HEALTH & IMMUNIZATION RECORDS

NURSING STUDENT HEALTH & IMMUNIZATION RECORDS NURSING STUDENT HEALTH & IMMUNIZATION RECORDS *********************************** COMPLETE THE ATTACHED HEALTH PACKET AND SUBMIT TO THE NURSING DEPARTMENT NO LATER THAN THE ASN ORIENTATION. **************************************

More information

Good Samaritan Inpatient Rehabilitation Program

Good Samaritan Inpatient Rehabilitation Program Good Samaritan Inpatient Rehabilitation Program Living at your full potential. Welcome When people are sick or injured, our goal is their maximum recovery. We help people live to their full potential.

More information

Dayton Audubon Society 1375 E. Siebenthaler Avenue Dayton, Ohio 45415-5398

Dayton Audubon Society 1375 E. Siebenthaler Avenue Dayton, Ohio 45415-5398 1375 E. Siebenthaler Avenue Dayton, Ohio 45415-5398 Dear Applicant, Thank you for your interest in Dayton Audubon's Dick Dively Scholarship. This scholarship, begun in 1982, is designed to help college

More information

TSA TECHNOLOGY HONOR SOCIETY

TSA TECHNOLOGY HONOR SOCIETY PREFACE The TSA Technology Honor Society recognizes TSA members who excel in academics, leadership, and service to their school and community. The TSA Technology Honor Society is an opportunity for student

More information

Asteron Life Personal Insurance

Asteron Life Personal Insurance Asteron Life Personal Insurance What lump sum covers are available with Asteron Life Personal Insurance? Life Cover Life Cover insurance pays a lump sum of money if you pass away or become terminally ill.

More information

College Survey for Students with Brain Injury

College Survey for Students with Brain Injury Name Date Interviewer I. Demographics 1. Please fill in the following: (MM/DD/YYYY) (1) Date of birth / / (2) Date of brain injury (please estimate if you are not certain) / / 2. Sex (circle) Female Male

More information

Scholarship Application

Scholarship Application Scholarship Application Contact: Renée Bromfield, Director of Community Relations, at rbromfield@bethlehemcenter.org or call at 704-371-7404 Making A Difference Scholarship 2015 1. DEADLINE for scholarship

More information

REQUEST FOR ACCOMMODATIONS FOR NEW STUDENTS 2014-2015

REQUEST FOR ACCOMMODATIONS FOR NEW STUDENTS 2014-2015 REQUEST FOR ACCOMMODATIONS FOR NEW STUDENTS 2014-2015 No otherwise qualified individual with a disability shall, solely by reason of his disability, be excluded from the participation in, be denied the

More information

PACIFIC PHYSICAL THERAPY 14650 Aviation Blvd., Suite 200 Manhattan Beach, CA 90250. Referring Doctor: PLEASE PRINT CLEARLY Email Address:

PACIFIC PHYSICAL THERAPY 14650 Aviation Blvd., Suite 200 Manhattan Beach, CA 90250. Referring Doctor: PLEASE PRINT CLEARLY Email Address: PACIFIC PHYSICAL THERAPY 14650 Aviation Blvd., Suite 200 Manhattan Beach, CA 90250 Date: Referring Doctor: PLEASE PRINT CLEARLY First Name: Last Name: Height: Address: City, St., Zip:_ Email Address: _

More information

State and National Call Centers

State and National Call Centers State and National Call Centers Listed Alphabetical by Name Acadia Hospital Access Dept. 1-800-640-1211 AIDS 1-800-851-2437 AIDS Clinical Trials Information Service 1-800-874-2572 AIDS Hotline 1-800-851-2437

More information

Careers in Health and Social Care Jane Saunders, Head of Recruitment Faculty of Health and Wellbeing

Careers in Health and Social Care Jane Saunders, Head of Recruitment Faculty of Health and Wellbeing Careers in Health and Social Care Jane Saunders, Head of Recruitment Faculty of Health and Wellbeing Points to consider Technology or caring focus Scrutinise entry criteria On line prospectus Open Days

More information

REHAB XCEL, LLC. NEW PATIENT INFORMATION

REHAB XCEL, LLC. NEW PATIENT INFORMATION REHAB XCEL, LLC. NEW PATIENT INFORMATION DATE: NAME: LAST: FIRST: MID: MAIL ADDRESS: HOME PHONE: CELL PHONE: WORK PHONE: DATE OF BIRTH: SS# SEX: M OR F EMERGENCY CONTACT: PHONE: MARITAL STATUS: M OR S

More information

Florida International University College of Education Department of Leadership & Professional Studies

Florida International University College of Education Department of Leadership & Professional Studies Florida International University College of Education Department of Leadership & Professional Studies 11200 SW 8 th Street ZEB 230 A Miami, FL 33199 305-348-3506 Fax: 305-348-4125 Dear Counselor Education

More information

CURRICULUM VITAE. Professional Experience

CURRICULUM VITAE. Professional Experience Patrick D. Caffrey, Ph.D. Caffrey Comprehensive Services 8301 State Line Road, Suite 200 Kansas City, MO 64114 816-363-5600 ext. 4 pdcaffrey@aol.com www.caffreycs.com CURRICULUM VITAE Summary: Nearly 30

More information

First Notice of Claim for Illness or Injury

First Notice of Claim for Illness or Injury How to help us process your claim Checklist Before submitting your claim form, make sure you can tick all the boxes below: Illness or Injury claims - documents required Section A: Statement of claimant

More information

First Steps for Newcomers to the San Francisco Bay Area. Bay Area School Systems and Enrollment Procedures

First Steps for Newcomers to the San Francisco Bay Area. Bay Area School Systems and Enrollment Procedures First Steps for Newcomers to the San Francisco Bay Area Community Connection s First Steps information sheets answer frequently asked questions about various aspects of SF Bay Area living Bay Area School

More information

Hispanic Scholarship Endowment Fund 2015 SCHOLARSHIP APPLICATION

Hispanic Scholarship Endowment Fund 2015 SCHOLARSHIP APPLICATION Hispanic Scholarship Endowment Fund 2015 SCHOLARSHIP APPLICATION SPONSORED BY: Ibero-American Action League, Inc. (585) 256-8900, 442-0683 fax www.iaal.org Applications must be received by: Friday, March

More information

Occupational Therapist Overview The Field - Preparation - Day in the Life - Earnings - Employment - Career Path Forecast - Professional Organizations

Occupational Therapist Overview The Field - Preparation - Day in the Life - Earnings - Employment - Career Path Forecast - Professional Organizations Occupational Therapist Overview The Field - Preparation - Day in the Life - Earnings - Employment - Career Path Forecast - Professional Organizations The Field Occupational therapists help patients improve

More information

Running head: PERSONAL PHILOSOPHY OF THERAPEUTIC RECREATION 1

Running head: PERSONAL PHILOSOPHY OF THERAPEUTIC RECREATION 1 Running head: PERSONAL PHILOSOPHY OF THERAPEUTIC RECREATION 1 Personal Philosophy of Therapeutic Recreation Maggie Whaley Grand Valley State University REC 404 PERSONAL PHILOSOPHY OF THERAPEUTIC RECREATION

More information

C Career Counselor I Recruiter

C Career Counselor I Recruiter Last Name First Middle (Optional) Race/Ethnic Group Date of application Street address Counseling Concentration Desired E-mail Address City State ZIP code Semester/Year Applying For Home: Cell: Work: How

More information

Mount Sinai Rehabilitation Center. 2014 Outcomes. Mount Sinai Rehabilitation Center 2014 Outcomes

Mount Sinai Rehabilitation Center. 2014 Outcomes. Mount Sinai Rehabilitation Center 2014 Outcomes Mount Sinai Rehabilitation Center 2014 Outcomes Mount Sinai Rehabilitation Center 2014 Outcomes TABLE OF CONTENTS A Message from the Chair... 3 About Our Programs. 4-5 Inpatient Rehabilitation. 6-12 Outpatient

More information

Georgia Department of Education Grade 3 Career Development Activity Human Services Estimated Time: 45 Minutes

Georgia Department of Education Grade 3 Career Development Activity Human Services Estimated Time: 45 Minutes Goal Students will identify careers as a Georgia career cluster Objectives define a career cluster as a grouping of occupations with common skills and knowledge identify sample occupations aligned with

More information

EARLY LEARNING OCCUPATIONAL THERAPIST (New position)

EARLY LEARNING OCCUPATIONAL THERAPIST (New position) Edmonton Catholic Schools is now accepting applications for the position of (10 mth) EARLY LEARNING OCCUPATIONAL THERAPIST (New position) Edmonton Catholic Schools is a large urban school district whose

More information

LA OWCA Second Injury Board Knowledge Questionnaire WARNING

LA OWCA Second Injury Board Knowledge Questionnaire WARNING 1001 North 23 rd Street Post Office Box 44187 Baton Rouge, LA 70804-4187 (O) 225-342-7866 800-201-2493 (F) 225-219-5968 Bobby Jindal, Governor Curt Eysink, Executive Director Office of Workers Compensation

More information

Access to over 53,000 of the world s leading medical experts, from your first day of cover.

Access to over 53,000 of the world s leading medical experts, from your first day of cover. For customers Friends Life Individual Protection providing access to Best Doctors Access to over 53,000 of the world s leading medical experts, from your first day of cover. A second medical opinion could

More information

THE MARKET AT A GLANCE.

THE MARKET AT A GLANCE. 1 BUSINESS PROTECTION SETTING UP BUSINESS PROTECTION POLICIES CRITICAL ILLNESS COVER COMPETITOR COMPARISON THE MARKET AT A GLANCE. We believe our Critical Illness Cover offers a competitive alternative

More information

INTERNATIONAL ASSOCIATION OF SICKLE CELL NURSES AND PHYSICIAN ASSISTANTS, INC.

INTERNATIONAL ASSOCIATION OF SICKLE CELL NURSES AND PHYSICIAN ASSISTANTS, INC. INTERNATIONAL ASSOCIATION OF SICKLE CELL NURSES AND PHYSICIAN ASSISTANTS, INC. SCHOLARSHIP PROGRAM APPLICATION The International Association of Sickle Cell Nurses and Physician Assistants, Inc. has established

More information

For customers Friends Life Individual Protection. Childcover benefit

For customers Friends Life Individual Protection. Childcover benefit For customers Friends Life Individual Protection Childcover benefit Helping to protect the whole family Most parents don t want to think about what would happen if their child became critically ill. However,

More information

REHAB RESOURCES, INC. CONSENT FOR TREATMENT ASSIGNMENT OF BENEFITS BILLING AUTHORZATION ADULT (18 years and over)

REHAB RESOURCES, INC. CONSENT FOR TREATMENT ASSIGNMENT OF BENEFITS BILLING AUTHORZATION ADULT (18 years and over) CONSENT FOR TREATMENT ASSIGNMENT OF BENEFITS BILLING AUTHORZATION ADULT (18 years and over) Rehab Resources, Inc. is a certified agency that provides outpatient therapy services. Occupational, Physical,

More information

Transition Notification Referral for Vocational Rehabilitation Services

Transition Notification Referral for Vocational Rehabilitation Services Kansas Department of Social and Vocational Rehabilitation Services Transition Notification Referral for Vocational Rehabilitation Services From: School _ Address Keystone Learning Services 500 Sunflower

More information

EUROPEAN BOARD OF PHYSICAL AND REHABILITATION MEDICINE LOGBOOK EUROPEAN UNION OF MEDICAL SPECIALISTS UEMS

EUROPEAN BOARD OF PHYSICAL AND REHABILITATION MEDICINE LOGBOOK EUROPEAN UNION OF MEDICAL SPECIALISTS UEMS EUROPEAN BOARD OF PHYSICAL AND REHABILITATION MEDICINE LOGBOOK EUROPEAN UNION OF MEDICAL SPECIALISTS UEMS IDENTIFICATION... 2 INSTRUCTIONS FOR USE... 3 THE TRAINING COURSE... 3 TRAINING PROGRAMME... 4

More information

Rehabilitation Medicine Service for Adults with Physical Disabilities

Rehabilitation Medicine Service for Adults with Physical Disabilities Rehabilitation Medicine Service for Adults with Physical Disabilities Information for Professionals Rehabilitation Medicine Service Community & Therapy Services Group This leaflet has been designed to

More information

Marianjoy Physical Therapy and. A Leader in Rehabilitation

Marianjoy Physical Therapy and. A Leader in Rehabilitation Marianjoy Physical Therapy and Outpatient Services A Leader in Rehabilitation Choose Wisely Choose Marianjoy Marianjoy Distinctly Different Marianjoy provides a complete range of rehabilitation services

More information

Dear Applicant: PROGRAM.APP\PTA APPLICATION 8/14 (1)

Dear Applicant: PROGRAM.APP\PTA APPLICATION 8/14 (1) Dear Applicant: The process for applying to the Physical Therapist Assistant (PTA) Program at Southern Illinois University Carbondale (SIUC) consists of the following steps: 1. Admission into the University

More information

Re-assessing career pathways after Brain Injury

Re-assessing career pathways after Brain Injury Re-assessing career pathways after Brain Injury The Cedar Foundation Brain Injury Services Vocational Rehabilitation Service Targets people with complex disabilities as a result of brain injury. Flexible,

More information

Franklin Military Academy

Franklin Military Academy Franklin Military Academy 2015-2016 Application For Rising 6th, 9th, and 10th Graders DUE JANUARY 16, 2015 INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED Application Timeline 2015-2016 November 1, 2014

More information

Physical & Health. Impairments (PHI) Education Specialist Credential Program. Overview of the PHI. Sherwood J. Best, CSULA

Physical & Health. Impairments (PHI) Education Specialist Credential Program. Overview of the PHI. Sherwood J. Best, CSULA Physical & Health Impairments (PHI) Overview of the PHI Education Specialist Credential Program Sherwood J. Best, CSULA Federal Disability Categories Served via the PHI Credential Orthopedic Impairments

More information

Physical Therapy Assistant

Physical Therapy Assistant Physical Therapy Assistant INDIVIDUAL PROGRAM INFORMATION 2015 2016 866.Macomb1 (866.622.6621) www.macomb.edu Physical Therapist Assistant PROGRAM OPTIONS CREDENTIAL TITLE CREDIT HOURS REQUIRED NOTES Associate

More information

Business Loan Insurance Plan Critical Illness Claim - Policy 57903

Business Loan Insurance Plan Critical Illness Claim - Policy 57903 Business Loan Insurance Plan Critical Illness Claim - Policy 57903 RBC use only Before submitting a critical illness claim: Complete and sign the Claimant s Statement for your critical illness. Please

More information

Why CI? Critical Illness Protection from Transamerica for a Broader Spectrum of Coverage

Why CI? Critical Illness Protection from Transamerica for a Broader Spectrum of Coverage Why CI? Critical Illness Protection from Transamerica for a Broader Spectrum of Coverage What is Critical Illness Protection? Critical Illness Protection is a form of insurance that provides you with a

More information

Comprehensive Special Education Plan. Programs and Services for Students with Disabilities

Comprehensive Special Education Plan. Programs and Services for Students with Disabilities Comprehensive Special Education Plan Programs and Services for Students with Disabilities The Pupil Personnel Services of the Corning-Painted Post Area School District is dedicated to work collaboratively

More information

Student Fieldwork Manual Department of Occupational Therapy San Jose State University

Student Fieldwork Manual Department of Occupational Therapy San Jose State University Student Fieldwork Manual Department of Occupational Therapy San Jose State University Introduction to Fieldwork Entry level education for occupational therapists requires the successful completion of both

More information

Rehab Realities. Sharing the Scoop on Alternative Rehabilitation Services with Nicholas Nilest, Dustin McArthur and Jacque Roberts

Rehab Realities. Sharing the Scoop on Alternative Rehabilitation Services with Nicholas Nilest, Dustin McArthur and Jacque Roberts Rehab Realities Sharing the Scoop on Alternative Rehabilitation Services with Nicholas Nilest, Dustin McArthur and Jacque Roberts [Jody Joseph Marmel] Due to a vast array of medical conditions, rehabilitation

More information

J. PATRICK HACKNEY ALABAMA DISABILITIES ADVOCACY PROGRAM

J. PATRICK HACKNEY ALABAMA DISABILITIES ADVOCACY PROGRAM J. PATRICK HACKNEY ALABAMA DISABILITIES ADVOCACY PROGRAM WHAT IS MEDICAID? Medicaid is a joint state/federal program that provides medical assistance for certain individuals and families with low income

More information

CNR S SHORT TERM REHABILITATION

CNR S SHORT TERM REHABILITATION CNR S SHORT TERM REHABILITATION A Leader in Innovative Therapies A Member of the Beth Abraham Family of Health Services Center for Nursing and Rehabilitation Where Healing Hands Lead You Home CNR s innovative

More information

Patient Information. Date: Date of Birth: / / Name: Social Security: _- - Address: Street City State Zip

Patient Information. Date: Date of Birth: / / Name: Social Security: _- - Address: Street City State Zip Personal Insurance Intake Form Patient Information Date of Birth: / / Social Security: _- - Address: Street City State Zip Email Address: Home Phone: Sex: M or F Work Phone:. Cell Phone: Height: Weight:

More information

2012 COMMUNITY SERVED OBSERVATIONS FROM THE 2012 CHNA:

2012 COMMUNITY SERVED OBSERVATIONS FROM THE 2012 CHNA: BACHARACH INSTITUTE FOR REHABILITATION COMMUNITY HEALTH NEEDS IMPLEMENTATION STRATEGY Adopted by the Board of Governors on December 10, 2013 INTRODUCTION conducted a Community Health Needs Assessment in

More information

9-12+ and Vocational Program 1360 East Irving Park Road Streamwood, Illinois 60107 Phone: 630-540-3900 Fax: 630-540-3908

9-12+ and Vocational Program 1360 East Irving Park Road Streamwood, Illinois 60107 Phone: 630-540-3900 Fax: 630-540-3908 9-12+ and Vocational Program 1360 East Irving Park Road Streamwood, Illinois 60107 Phone: 630-540-3900 Fax: 630-540-3908 Our Vision is to provide HOPE, enlightenment and excitement for our students, families,

More information

Kimberley Sweet. Dear Prospective Volunteer:

Kimberley Sweet. Dear Prospective Volunteer: Dear Prospective Volunteer: We are excited that you have expressed an interest in volunteering at Doctors Hospital at White Rock Lake. As a volunteer, you will be providing services and support to patients,

More information