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HMOTA MEMBERSHIP
Putting together a directory so we can contact members when jobs come up in their area.
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* Indicates required question
Email
*
Your email
FIRST AND LAST NAME
*
Your answer
City
*
Your answer
State
Your answer
Phone number
Your answer
Are you an OT or a COTA?
*
OT
COTA
Other:
Business name, if you have a business
Your answer
Please check all services you offer.
*
OT home evaluations
OT attendant care evaluations
Design
Handyman services-small jobs, grab bars, ramps, lifts.
Full service remodeling and construction
Medicare credentialed.
Other:
Required
Any specialties like pediatrics, autism, Parkinsons etc.?
Your answer
Any certifications?
*
CAPS
Executive certificate of home modifications (ECHM)
CHAMPS
No, not yet.
Other:
Required
Anything you'd like to share?
Your answer
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