APTA Alaska Physical Therapy Community Clinic

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APTA Alaska Physical Therapy Community Clinic - Volunteer Interest Form

Thank you for your interest in volunteering with the APTA Alaska Physical Therapy Community Clinic! For more information on the clinic, please visit https://www.aptaalaska.org/alaska-physical-therapy-community-clinic/.

Please answer the following questions. We will reach out to you as soon as possible with more information.

Name *

E-Mail Address *

Cell Phone #

Which clinic(s) are you interested in volunteering at? *

Anchorage (206 E Northern Lights Blvd)

Wasilla (984 N Meridian Pl)

Fairbanks (3677 College Rd Ste 13)

Required

Are you a: PT, PTA, or other? *

PTA

Other:

How would you like to help?

(Please note: there is no commitment in selecting any of these options. This simply allows us permission to reach out regarding your interest in helping)

Saturday Volunteer Clinician (provide patient care in Anchorage; occasional Saturdays)

Saturday Volunteer Admin (providing intake paperwork, checking-in patients; occasional Saturdays)

Patient Scheduling (<5 minutes per week; assisting with patient scheduling, returning communication, reminder calls, etc)

"All-Alaska" interest (offering pro bono services as a remote clinic site elsewhere in Alaska)

Other:

Required

If interested in helping with patient care, what is your area of practice or specialty? N/A if none.

Examples: orthopedics, neurology, pediatric, cardiovascular/pulmonary, women's health, oncology, etc

Do you speak any other languages besides English? If so, please list below. N/A if none. *

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