2015 NCPTA Fall Conference

1. 2015 NCPTA Fall Conference Registration Form
Please complete this form and mail it along with your fees to NCPTA. One form must be filled out for each
registrant and payment must accompany the registration form. Deadline for registration form is October 7,
2015. After that, please plan to register on-site for an additional $20 fee ($10 for students).
Name / Credentials ___________________________________________ Nickname ___________________
Mailing Address _________________________________________________________________________
City / State / Zip __________________________________________________________________________
Daytime Telephone Number ________________________________ E-mail _________________________
☐PT ☐PTA ☐Student ☐Other NCPTA Member? ☐Yes ☐No APTA Member? ☐Yes ☐No
I will be attending the following:
Thursday October 8, 2015
____ 8:00am-11:30am: How the Foot Drives Performance
____ 8:00am-11:30am: Vestibular Rehab
____ 8:00am-9:30am: My Patients Have Questions, and I
Need Answers
____ 10:00am-11:30am: Musculoskeletal Ultrasound
Imaging of the Shoulder in Physical Therapy
____ 11:45am-1:45pm: Keynote Luncheon: Why Don’t
Patients Get Better?
____ 2:00pm-5:30pm: Tai Chi and Lymphedema
____ 2:00pm-5:30pm: Core Stabilization
____ 2:00pm-3:30pm: Heart Failure: Management in the
Home
____ 4:00pm-5:30pm: There’s an App for That: Integrating
Mobile Technology into Physical Therapy
____ 4:00pm-5:30pm: Clinical Prediction Rules: An
Unbiased Critical Appraisal
Friday October 9, 2015
____ 8:00am-3:00pm: Enabling Healthy Behaviors:
Translating Theory into Practice
____ 8:00am-11:30am: Lumbar Motor Control – The
Australian Evidence Based Practice
____ 8:00am-11:30am: Current Concepts in 3D Evaluation
and Treatment of Adolescent Idiopathic Scoliosis
(AIS)
____ 8:00am-9:30am: Is Your Front Line Protecting Your
Quarterback? Best Practice for Outpatient
Administrative Processes
____ 8:00am-9:30am: Mirror Therapy for Pain and Motor
Recovery in the Neurologic Population Using a
Lower Extremity Mirror Box
____ 8:00am-9:30am: Overcoming Fear of Feedback –
Tools to Empower Students, Colleagues, and Staff
____ 10:00am-11:30am: Clinical Education SWOT Swap
____ 10:00am-11:30am: Application of Motor Learning
Principles and Neuroplasticity Utilizing Advanced
Technology: Promotion of Gait Recovery with
Patients after Neurological Injury
____ 10:00am-11:30am: Guidelines for the DPT Student:
Make the Most of Your Membership and Career
Opportunities
____ 1:30pm-3:00pm: Integrating Trigger Point,
Neurological and Functional Dry Needling Models
with manual Therapy and Corrective Exercise
____ 1:30pm-3:00pm: Fitness from Toes to Abs (pediatric)
____ 1:30pm-3:00pm: Evidence Based Practice: Finding
and Interpreting Evidence Related to Practice
____ 1:30pm-3:00pm: An Evidence Based Approach to
Identification, Modification, and Implementation of a
Fall Reduction Program in the Aging IDD Population
____ 1:30pm-3:00pm: Student Job Hunt 101
Saturday October 10, 2015
____ 8:30am-11:45am: Spinal Imaging Across the
Continuum: Interpreting and Making Decisions for
Conservative, Traumatic, and Post-Operative Care
____ 8:30am-11:45am: The Black Hole of Orthopedics –
Current Concepts in Evaluation and Management of
Patellofemoral Pain Syndrome
____ 8:30am-11:45am: “More Bang for the Buck” – ICF and
Impairment Based Treatment
____ 8:30am-10:00am: The SI Joint as a “Pain Generator”
Clinical Examination and Differential Diagnosis
____ 10:15am-11:45am: An Introduction to Instrument-
Assisted Soft Tissue Mobilization Highlighting the
Graston Technique
____ 12:00pm-3:30pm: NCPTA Awards Luncheon ($25.00)
Registration Fee (please Circle)
Day 1
(7 hours)
Day 2
(4.5 hours)
Day 3
(3 hours)
NCPTA PT
Member
$175 $115 $75
PT Non-
Member
$225 $155 $90
NCPTA PTA
Member
$140 $90 $60
PTA Non-
Member
$175 $115 $75
NCPTA
Student
Member
$25 $25 $20
Student Non-
Member
$30 $30 $25
Total Registration Fee Enclosed $____________
Please make checks payable to NCPTA
OR, pay by credit card: ☐Visa ☐MasterCard ☐Discover
Card Number _______________________________________
3-digit Security Code (if Business Card) __________________
Cardholder’s Name (please print) ________________________
Billing Zip Code _____________________________________
Amount to be charged $ ___________ Expiration Date ______
Signature __________________________________________
Mail or Fax (with credit card info) to:
North Carolina Physical Therapy Association
315 West Millbrook Road, Suite 105 Raleigh, NC 27609
Questions, call the NCPTA Office at 919-841-0268
FAX: 919-841-0269 or e-mail: ncpta@ncpt.org