{"id":2343,"date":"2021-11-02T12:33:32","date_gmt":"2021-11-02T16:33:32","guid":{"rendered":"https:\/\/wwwcp.umes.edu\/pt\/?page_id=2343"},"modified":"2021-11-21T18:14:22","modified_gmt":"2021-11-21T22:14:22","slug":"alumni-survey","status":"publish","type":"page","link":"https:\/\/wwwcp.umes.edu\/pt\/alumni-survey\/","title":{"rendered":"Alumni Survey"},"content":{"rendered":"\n<p class=\"has-text-align-center wp-block-paragraph\">&nbsp;&nbsp;<strong>UNIVERSITY OF MARYLAND EASTERN SHORE<br>DEPARTMENT OF PHYSICAL THERAPY<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><strong>ALUMNI SURVEY<\/strong>&nbsp;<br><br>You have the option to remain anonymous (if this option is chosen, please place an \u201cX\u201d in the required field).&nbsp;<\/p>\n\n\n\n<div class=\"forminator-guttenberg\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-2355 forminator-design--material forminator-enclosed forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-2355\" data-uid=\"6a4549c42fa04\"><br\/><\/div><form\r\n\t\t\t\tid=\"forminator-module-2355\"\r\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-2355 forminator-design--material forminator-enclosed forminator_ajax\"\r\n\t\t\t\tmethod=\"post\"\r\n\t\t\t\tdata-forminator-render=\"0\"\r\n\t\t\t\tdata-form-id=\"2355\"\r\n\t\t\t\t data-color-option=\"default\" data-design=\"material\" data-grid=\"enclosed\" style=\"display: none;\"\r\n\t\t\t\tdata-uid=\"6a4549c42fa04\"\r\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_6a4549c42fa04\" id=\"forminator-field-name-1_6a4549c42fa04-label\" class=\"forminator-label\">Name<\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"\" id=\"forminator-field-name-1_6a4549c42fa04\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" autocomplete=\"name\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_6a4549c42fa04\" id=\"forminator-field-phone-1_6a4549c42fa04-label\" class=\"forminator-label\">Phone<\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1_6a4549c42fa04\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6a4549c42fa04\" id=\"forminator-field-email-1_6a4549c42fa04-label\" class=\"forminator-label\">Email Address<\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"\" id=\"forminator-field-email-1_6a4549c42fa04\" class=\"forminator-input forminator-email--field\" data-required=\"\" aria-required=\"false\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-1\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-1\"><p><strong>I. \u00a0 \u00a0 \u00a0BACKGROUND INFORMATION<br \/><\/strong><\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_6a4549c42fa04\" id=\"forminator-field-text-1_6a4549c42fa04-label\" class=\"forminator-label\">A. In what year did you graduate from the University of Maryland Eastern Shore?<\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1_6a4549c42fa04\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-1\" class=\"forminator-field-checkbox forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-1-6a4549c42fa04-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-1-6a4549c42fa04-label\" class=\"forminator-label\">B. In which of the following physical therapy settings have you been employed since graduation? (check all that apply)<\/span><label id=\"forminator-field-checkbox-1-1-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-1-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"General Hospital\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"general-hospital\" id=\"forminator-field-checkbox-1-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-1-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">General Hospital<\/span><\/label><label id=\"forminator-field-checkbox-1-2-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-2-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Rehabilitation Facility\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"rehabilitation-facility\" id=\"forminator-field-checkbox-1-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-2-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Rehabilitation Facility<\/span><\/label><label id=\"forminator-field-checkbox-1-3-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-3-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Skilled Nursing Facility\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"skilled-nursing-facility\" id=\"forminator-field-checkbox-1-3-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-3-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Skilled Nursing Facility<\/span><\/label><label id=\"forminator-field-checkbox-1-4-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-4-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Home Health Agency\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"home-health-agency\" id=\"forminator-field-checkbox-1-4-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-4-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Home Health Agency<\/span><\/label><label id=\"forminator-field-checkbox-1-5-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-5-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Outpatient Clinic or Private Practice\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"outpatient-clinic-or-private-practice\" id=\"forminator-field-checkbox-1-5-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-5-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Outpatient Clinic or Private Practice<\/span><\/label><label id=\"forminator-field-checkbox-1-6-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-6-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Public School System\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"public-school-system\" id=\"forminator-field-checkbox-1-6-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-6-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Public School System<\/span><\/label><label id=\"forminator-field-checkbox-1-7-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-7-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"U.S. Public Health Service\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"us-public-health-service\" id=\"forminator-field-checkbox-1-7-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-7-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">U.S. Public Health Service<\/span><\/label><label id=\"forminator-field-checkbox-1-8-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-8-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Armed Forces\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"armed-forces\" id=\"forminator-field-checkbox-1-8-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-8-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Armed Forces<\/span><\/label><label id=\"forminator-field-checkbox-1-9-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-9-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"H.M.O.\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"hmo\" id=\"forminator-field-checkbox-1-9-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-9-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">H.M.O.<\/span><\/label><label id=\"forminator-field-checkbox-1-10-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-10-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Veterans Administration\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"veterans-administration\" id=\"forminator-field-checkbox-1-10-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-10-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Veterans Administration<\/span><\/label><label id=\"forminator-field-checkbox-1-11-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-11-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Other (please specify)\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"other-please-specify\" id=\"forminator-field-checkbox-1-11-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-11-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Other (please specify)<\/span><\/label><label id=\"forminator-field-checkbox-1-12-6a4549c42fa04-label\" for=\"forminator-field-checkbox-1-12-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Not employed in Physical Therapy\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"not-employed-in-physical-therapy\" id=\"forminator-field-checkbox-1-12-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-1-12-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Not employed in Physical Therapy<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-2\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-2\"><p><strong>C. \u00a0 \u00a0\u00a0Please provide the following information on your first and present employment situations:<\/strong><\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_6a4549c42fa04\" id=\"forminator-field-text-2_6a4549c42fa04-label\" class=\"forminator-label\">1. \u00a0First Position | Location:City<\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"\" id=\"forminator-field-text-2_6a4549c42fa04\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_6a4549c42fa04\" id=\"forminator-field-text-3_6a4549c42fa04-label\" class=\"forminator-label\">State<\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3_6a4549c42fa04\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-1-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-1-6a4549c42fa04-label\" class=\"forminator-label\">Setting<\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Full-Time\"><input type=\"radio\" name=\"radio-1\" value=\"fulltime\" id=\"forminator-field-radio-1-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Full-Time<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"Part-Time\"><input type=\"radio\" name=\"radio-1\" value=\"parttime\" id=\"forminator-field-radio-1-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Part-Time<\/span><\/label><label id=\"forminator-field-radio-1-label-3\" for=\"forminator-field-radio-1-3-6a4549c42fa04\" class=\"forminator-radio\" title=\"Suburban\"><input type=\"radio\" name=\"radio-1\" value=\"suburban\" id=\"forminator-field-radio-1-3-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-1-label-3\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Suburban<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-2\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-2-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-2-6a4549c42fa04-label\" class=\"forminator-label\">Radio<\/span><label id=\"forminator-field-radio-2-label-1\" for=\"forminator-field-radio-2-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Option 1\"><input type=\"radio\" name=\"radio-2\" value=\"one\" id=\"forminator-field-radio-2-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-2-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Option 1<\/span><\/label><label id=\"forminator-field-radio-2-label-2\" for=\"forminator-field-radio-2-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"Option 2\"><input type=\"radio\" name=\"radio-2\" value=\"two\" id=\"forminator-field-radio-2-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-2-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Option 2<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_6a4549c42fa04\" id=\"forminator-field-text-4_6a4549c42fa04-label\" class=\"forminator-label\">2. \u00a0Present Position | Location: City<\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4_6a4549c42fa04\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-8\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-8_6a4549c42fa04\" id=\"forminator-field-text-8_6a4549c42fa04-label\" class=\"forminator-label\">State<\/label><input type=\"text\" name=\"text-8\" value=\"\" placeholder=\"\" id=\"forminator-field-text-8_6a4549c42fa04\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-3\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-3-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-3-6a4549c42fa04-label\" class=\"forminator-label\">Setting:<\/span><label id=\"forminator-field-radio-3-label-1\" for=\"forminator-field-radio-3-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Urban\"><input type=\"radio\" name=\"radio-3\" value=\"urban\" id=\"forminator-field-radio-3-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-3-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Urban<\/span><\/label><label id=\"forminator-field-radio-3-label-2\" for=\"forminator-field-radio-3-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"Rural\"><input type=\"radio\" name=\"radio-3\" value=\"rural\" id=\"forminator-field-radio-3-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-3-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Rural<\/span><\/label><label id=\"forminator-field-radio-3-label-3\" for=\"forminator-field-radio-3-3-6a4549c42fa04\" class=\"forminator-radio\" title=\"Suburban\"><input type=\"radio\" name=\"radio-3\" value=\"suburban\" id=\"forminator-field-radio-3-3-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-3-label-3\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Suburban<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-4\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-4-6a4549c42fa04-label\"><label id=\"forminator-field-radio-4-label-1\" for=\"forminator-field-radio-4-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Full-Time\"><input type=\"radio\" name=\"radio-4\" value=\"fulltime\" id=\"forminator-field-radio-4-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-4-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Full-Time<\/span><\/label><label id=\"forminator-field-radio-4-label-2\" for=\"forminator-field-radio-4-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"Part-Time\"><input type=\"radio\" name=\"radio-4\" value=\"parttime\" id=\"forminator-field-radio-4-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-4-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Part-Time<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-5\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-5-6a4549c42fa04-label\"><label id=\"forminator-field-radio-5-label-1\" for=\"forminator-field-radio-5-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Not currently employed in PT\"><input type=\"radio\" name=\"radio-5\" value=\"not-currently-employed-in-pt\" id=\"forminator-field-radio-5-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-5-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Not currently employed in PT<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-6\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-6-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-6-6a4549c42fa04-label\" class=\"forminator-label\">3. Have any of your positions been in management\/administration?<\/span><label id=\"forminator-field-radio-6-label-1\" for=\"forminator-field-radio-6-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-6\" value=\"yes\" id=\"forminator-field-radio-6-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-6-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-6-label-2\" for=\"forminator-field-radio-6-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-6\" value=\"no\" id=\"forminator-field-radio-6-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-6-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-1\" class=\"forminator-field-number forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-1_6a4549c42fa04\" id=\"forminator-field-number-1_6a4549c42fa04-label\" class=\"forminator-label\">If yes, for how many years?<\/label><input name=\"number-1\" value=\"\" placeholder=\"\" id=\"forminator-field-number-1_6a4549c42fa04\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"\" data-decimals=\"0\" aria-required=\"false\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" type=\"number\" step=\"any\" min=\"1\" max=\"150\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-5\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-5_6a4549c42fa04\" id=\"forminator-field-text-5_6a4549c42fa04-label\" class=\"forminator-label\">If yes, please describe your position<\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"\" id=\"forminator-field-text-5_6a4549c42fa04\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"html-4\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-4\"><p><strong>II. \u00a0 \u00a0 GENERAL INFORMATION:<br \/><\/strong><\/p><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-7\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-7-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-7-6a4549c42fa04-label\" class=\"forminator-label\">A. Are you satisfied with your current abilities to examine, evaluate, and devise plans of care for patients\/clients?<\/span><label id=\"forminator-field-radio-7-label-1\" for=\"forminator-field-radio-7-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-7\" value=\"yes\" id=\"forminator-field-radio-7-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-7-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-7-label-2\" for=\"forminator-field-radio-7-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-7\" value=\"no\" id=\"forminator-field-radio-7-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-7-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-8\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-8-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-8-6a4549c42fa04-label\" class=\"forminator-label\">B. Are you satisfied with your contributions to society through your physical therapy practice and other professional activities?<\/span><label id=\"forminator-field-radio-8-label-1\" for=\"forminator-field-radio-8-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-8\" value=\"yes\" id=\"forminator-field-radio-8-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-8-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-8-label-2\" for=\"forminator-field-radio-8-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-8\" value=\"no\" id=\"forminator-field-radio-8-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-8-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-9\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-9-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-9-6a4549c42fa04-label\" class=\"forminator-label\">C. Are you currently a member of the American Physical Therapy Association (A.P.T.A.)?<\/span><label id=\"forminator-field-radio-9-label-1\" for=\"forminator-field-radio-9-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-9\" value=\"yes\" id=\"forminator-field-radio-9-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-9-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-9-label-2\" for=\"forminator-field-radio-9-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-9\" value=\"no\" id=\"forminator-field-radio-9-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-9-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-10\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-10-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-10-6a4549c42fa04-label\" class=\"forminator-label\">D. Are you currently a member of any other professional organizations related to physical therapy?<\/span><label id=\"forminator-field-radio-10-label-1\" for=\"forminator-field-radio-10-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-10\" value=\"yes\" id=\"forminator-field-radio-10-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-10-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-10-label-2\" for=\"forminator-field-radio-10-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-10\" value=\"no\" id=\"forminator-field-radio-10-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-10-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-6\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-6_6a4549c42fa04\" id=\"forminator-field-text-6_6a4549c42fa04-label\" class=\"forminator-label\">If yes: Please identify the organization<\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6_6a4549c42fa04\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-11\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-11-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-11-6a4549c42fa04-label\" class=\"forminator-label\">E. Have you served on committees or as an officer for the A.P.T.A. at the regional, state and\/or national level?<\/span><label id=\"forminator-field-radio-11-label-1\" for=\"forminator-field-radio-11-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-11\" value=\"yes\" id=\"forminator-field-radio-11-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-11-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-11-label-2\" for=\"forminator-field-radio-11-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-11\" value=\"no\" id=\"forminator-field-radio-11-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-11-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_6a4549c42fa04\" id=\"forminator-field-textarea-2_6a4549c42fa04-label\" class=\"forminator-label\">If yes: Please describe<\/label><textarea name=\"textarea-2\" placeholder=\"\" id=\"forminator-field-textarea-2_6a4549c42fa04\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-12\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-12-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-12-6a4549c42fa04-label\" class=\"forminator-label\">F. Are you currently an American Board of Physical Therapy Certified Clinical Specialist?<\/span><label id=\"forminator-field-radio-12-label-1\" for=\"forminator-field-radio-12-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-12\" value=\"yes\" id=\"forminator-field-radio-12-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-12-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-12-label-2\" for=\"forminator-field-radio-12-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-12\" value=\"no\" id=\"forminator-field-radio-12-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-12-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-7\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-7_6a4549c42fa04\" id=\"forminator-field-text-7_6a4549c42fa04-label\" class=\"forminator-label\">If yes, in which specialty area?<\/label><input type=\"text\" name=\"text-7\" value=\"\" placeholder=\"\" id=\"forminator-field-text-7_6a4549c42fa04\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-13\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-13-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-13-6a4549c42fa04-label\" class=\"forminator-label\">G. Have you received any awards, special recognition, specialized training, and\/or certifications?<\/span><label id=\"forminator-field-radio-13-label-1\" for=\"forminator-field-radio-13-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-13\" value=\"yes\" id=\"forminator-field-radio-13-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-13-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-13-label-2\" for=\"forminator-field-radio-13-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-13\" value=\"no\" id=\"forminator-field-radio-13-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-13-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-3\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-3_6a4549c42fa04\" id=\"forminator-field-textarea-3_6a4549c42fa04-label\" class=\"forminator-label\">If yes, please describe:<\/label><textarea name=\"textarea-3\" placeholder=\"\" id=\"forminator-field-textarea-3_6a4549c42fa04\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-14\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-14-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-14-6a4549c42fa04-label\" class=\"forminator-label\">H. Have you been a Clinical Instructor for physical therapy or physical therapist assistant students?<\/span><label id=\"forminator-field-radio-14-label-1\" for=\"forminator-field-radio-14-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-14\" value=\"yes\" id=\"forminator-field-radio-14-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-14-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-14-label-2\" for=\"forminator-field-radio-14-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-14\" value=\"no\" id=\"forminator-field-radio-14-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-14-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"number-2\" class=\"forminator-field-number forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-2_6a4549c42fa04\" id=\"forminator-field-number-2_6a4549c42fa04-label\" class=\"forminator-label\">If yes:<\/label><input name=\"number-2\" value=\"\" placeholder=\"\" id=\"forminator-field-number-2_6a4549c42fa04\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"\" data-decimals=\"0\" aria-required=\"false\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" type=\"number\" step=\"any\" min=\"1\" max=\"150\" \/><\/div><\/div><div id=\"number-3\" class=\"forminator-field-number forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-3_6a4549c42fa04\" id=\"forminator-field-number-3_6a4549c42fa04-label\" class=\"forminator-label\">Number of P.T. students<\/label><input name=\"number-3\" value=\"\" placeholder=\"\" id=\"forminator-field-number-3_6a4549c42fa04\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"\" data-decimals=\"0\" aria-required=\"false\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" type=\"number\" step=\"any\" min=\"1\" max=\"150\" \/><\/div><\/div><div id=\"number-4\" class=\"forminator-field-number forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-4_6a4549c42fa04\" id=\"forminator-field-number-4_6a4549c42fa04-label\" class=\"forminator-label\">Number of P.T.A. students<\/label><input name=\"number-4\" value=\"\" placeholder=\"\" id=\"forminator-field-number-4_6a4549c42fa04\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"\" data-decimals=\"0\" aria-required=\"false\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" type=\"number\" step=\"any\" min=\"1\" max=\"150\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-15\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-15-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-15-6a4549c42fa04-label\" class=\"forminator-label\">I. Are you an A.P.T.A. Credentialed Clinical Instructor?<\/span><label id=\"forminator-field-radio-15-label-1\" for=\"forminator-field-radio-15-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-15\" value=\"yes\" id=\"forminator-field-radio-15-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-15-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-15-label-2\" for=\"forminator-field-radio-15-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-15\" value=\"no\" id=\"forminator-field-radio-15-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-15-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_6a4549c42fa04\" id=\"forminator-field-date-1-picker_6a4549c42fa04-label\" class=\"forminator-label\">If yes: Date of training<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"\" placeholder=\"\" id=\"forminator-field-date-1-picker_6a4549c42fa04\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-2\" class=\"forminator-field-checkbox forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-2-6a4549c42fa04-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-2-6a4549c42fa04-label\" class=\"forminator-label\">J. Have you been involved in presenting workshops, lectures, seminars, or in-service presentations for any of the following groups?<\/span><label id=\"forminator-field-checkbox-2-1-6a4549c42fa04-label\" for=\"forminator-field-checkbox-2-1-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Your Department\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"your-department\" id=\"forminator-field-checkbox-2-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-2-1-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Your Department<\/span><\/label><label id=\"forminator-field-checkbox-2-2-6a4549c42fa04-label\" for=\"forminator-field-checkbox-2-2-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Other Disciplines\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"other-disciplines\" id=\"forminator-field-checkbox-2-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-2-2-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Other Disciplines<\/span><\/label><label id=\"forminator-field-checkbox-2-3-6a4549c42fa04-label\" for=\"forminator-field-checkbox-2-3-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Professional Groups\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"professional-groups\" id=\"forminator-field-checkbox-2-3-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-2-3-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Professional Groups<\/span><\/label><label id=\"forminator-field-checkbox-2-4-6a4549c42fa04-label\" for=\"forminator-field-checkbox-2-4-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Community Groups\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"community-groups\" id=\"forminator-field-checkbox-2-4-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-2-4-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Community Groups<\/span><\/label><label id=\"forminator-field-checkbox-2-5-6a4549c42fa04-label\" for=\"forminator-field-checkbox-2-5-6a4549c42fa04\" class=\"forminator-checkbox\" title=\"Entry-level P.T. or P.T.A. program(s)\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"entrylevel-pt-or-pta-programs\" id=\"forminator-field-checkbox-2-5-6a4549c42fa04\" aria-labelledby=\"forminator-field-checkbox-2-5-6a4549c42fa04-label\" data-calculation=\"0\"  \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Entry-level P.T. or P.T.A. program(s)<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-16\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-16-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-16-6a4549c42fa04-label\" class=\"forminator-label\">K. Have you earned an advanced degree (beyond entry-level) or are you presently seeking an advanced degree in physical therapy or any related area since graduation from UMES?<\/span><label id=\"forminator-field-radio-16-label-1\" for=\"forminator-field-radio-16-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Have earned advanced degree\"><input type=\"radio\" name=\"radio-16\" value=\"have-earned-advanced-degree\" id=\"forminator-field-radio-16-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-16-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Have earned advanced degree<\/span><\/label><label id=\"forminator-field-radio-16-label-2\" for=\"forminator-field-radio-16-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"Seeking advanced degree\"><input type=\"radio\" name=\"radio-16\" value=\"seeking-advanced-degree\" id=\"forminator-field-radio-16-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-16-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Seeking advanced degree<\/span><\/label><label id=\"forminator-field-radio-16-label-3\" for=\"forminator-field-radio-16-3-6a4549c42fa04\" class=\"forminator-radio\" title=\"Degree awarded\/seeking\"><input type=\"radio\" name=\"radio-16\" value=\"degree-awardedseeking\" id=\"forminator-field-radio-16-3-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-16-label-3\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Degree awarded\/seeking<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-17\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-17-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-17-6a4549c42fa04-label\" class=\"forminator-label\">L. Have you participated in any clinical research projects since graduation from UMES?<\/span><label id=\"forminator-field-radio-17-label-1\" for=\"forminator-field-radio-17-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-17\" value=\"yes\" id=\"forminator-field-radio-17-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-17-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-17-label-2\" for=\"forminator-field-radio-17-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-17\" value=\"no\" id=\"forminator-field-radio-17-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-17-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-4\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-4_6a4549c42fa04\" id=\"forminator-field-textarea-4_6a4549c42fa04-label\" class=\"forminator-label\">If yes, please describe research projects, publications, presentations:<\/label><textarea name=\"textarea-4\" placeholder=\"\" id=\"forminator-field-textarea-4_6a4549c42fa04\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-18\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-18-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-18-6a4549c42fa04-label\" class=\"forminator-label\">M. Have you participated in any physical therapy-related community service projects including health promotion and prevention programs in response to the needs of your community?<\/span><label id=\"forminator-field-radio-18-label-1\" for=\"forminator-field-radio-18-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-18\" value=\"yes\" id=\"forminator-field-radio-18-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-18-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-18-label-2\" for=\"forminator-field-radio-18-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-18\" value=\"no\" id=\"forminator-field-radio-18-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-18-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-5\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-5_6a4549c42fa04\" id=\"forminator-field-textarea-5_6a4549c42fa04-label\" class=\"forminator-label\">If yes, please describe<\/label><textarea name=\"textarea-5\" placeholder=\"\" id=\"forminator-field-textarea-5_6a4549c42fa04\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-19\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-19-6a4549c42fa04-label\"><span id=\"forminator-radiogroup-radio-19-6a4549c42fa04-label\" class=\"forminator-label\">N. Since graduation from UMES, have you participated in continuing education courses which have enhanced and\/or updated your knowledge and\/or skills for professional practice?<\/span><label id=\"forminator-field-radio-19-label-1\" for=\"forminator-field-radio-19-1-6a4549c42fa04\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-19\" value=\"yes\" id=\"forminator-field-radio-19-1-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-19-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-19-label-2\" for=\"forminator-field-radio-19-2-6a4549c42fa04\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-19\" value=\"no\" id=\"forminator-field-radio-19-2-6a4549c42fa04\" aria-labelledby=\"forminator-field-radio-19-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-6\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-6_6a4549c42fa04\" id=\"forminator-field-textarea-6_6a4549c42fa04-label\" class=\"forminator-label\">If yes, please describe<\/label><textarea name=\"textarea-6\" placeholder=\"\" id=\"forminator-field-textarea-6_6a4549c42fa04\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-7\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-7_6a4549c42fa04\" id=\"forminator-field-textarea-7_6a4549c42fa04-label\" class=\"forminator-label\">O. Please provide any comments that you would like to express regarding areas that have not been addressed in this survey.<\/label><textarea name=\"textarea-7\" placeholder=\"\" id=\"forminator-field-textarea-7_6a4549c42fa04\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"captcha-1\" class=\"forminator-field-captcha forminator-col forminator-col-12 \"><div class=\"forminator-captcha-left forminator-g-recaptcha recaptcha-invisible\" data-theme=\"light\" data-badge=\"inline\" data-sitekey=\"6LcCCBQdAAAAAP73y91aYkTmlJsRh0SvZzWKMuhk\" data-size=\"invisible\"><\/div> <\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\"><span>Submit Survey<\/span><span aria-hidden=\"true\"><\/span><\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"34126b6143\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/pt\/wp-json\/wp\/v2\/pages\/2343\" \/><input type=\"hidden\" name=\"form_id\" value=\"2355\"><input type=\"hidden\" name=\"page_id\" value=\"2343\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/wwwcp.umes.edu\/pt\/alumni-survey\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp;&nbsp;UNIVERSITY OF MARYLAND EASTERN SHOREDEPARTMENT OF PHYSICAL THERAPY ALUMNI SURVEY&nbsp; You have the option to remain anonymous (if this option is chosen, please place an \u201cX\u201d in the required field).&nbsp;&#8230;<span class=\"cpschool-read-more-link-holder\"><a class=\"btn btn-basic cpschool-read-more-link\" href=\"https:\/\/wwwcp.umes.edu\/pt\/alumni-survey\/\">Read more <span class=\"sr-only\">Alumni Survey<\/span><\/a><\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":46,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","footnotes":""},"folder":[],"class_list":["post-2343","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/wwwcp.umes.edu\/pt\/wp-json\/wp\/v2\/pages\/2343","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wwwcp.umes.edu\/pt\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/wwwcp.umes.edu\/pt\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/wwwcp.umes.edu\/pt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wwwcp.umes.edu\/pt\/wp-json\/wp\/v2\/comments?post=2343"}],"version-history":[{"count":0,"href":"https:\/\/wwwcp.umes.edu\/pt\/wp-json\/wp\/v2\/pages\/2343\/revisions"}],"wp:attachment":[{"href":"https:\/\/wwwcp.umes.edu\/pt\/wp-json\/wp\/v2\/media?parent=2343"}],"wp:term":[{"taxonomy":"folder","embeddable":true,"href":"https:\/\/wwwcp.umes.edu\/pt\/wp-json\/wp\/v2\/folder?post=2343"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}