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Postprofessional Clinical Residency and Fellowship Program Credentialing Application


The Postprofessional Clinical Residency and Fellowship Program Credentialing Application is available from this Web site as a Word 97 document. This format will allow you download the document to your computer and input your information directly into the application.
When accessing the document using MS Internet Explorer (you must have MS Office loaded as well), once you have hit the link below, the document will open automatically. For those using an Internet browser other than Internet Explorer, you will be asked to "save document as" before having access to the application. Save the document to your computer and begin working from there.

Clinical Residency and Fellowship Program Credentialing Application

Thank you for your interest in the Clinical Residency and Fellowship Program Credentialing Application. To better serve you, would you please answer the following questions:

1. Which of the following describes your status:
  residency/fellowship program director
individual considering developing a residency/fellowship
student
other

2. Which of the following describes your intended use of the application:
  apply for credentialing
assist in program development
research
school project

3. Would you like someone from the Professional Development Department to contact you?
  Yes (Please complete the contact information below)
No

4. Are you an APTA member?
  Yes
No

5. What are the barriers to starting a residency/fellowship program?
 

If you would like to be contacted, please compelte the below information.
Name:
Address:
Phone:
Email:

Related Files

Application Packet for Credentialing (Word Document)

 
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703/684-APTA (2782) * 800-999-2782 * 703/683-6748 (TDD)
703/684-7343 (fax)
 
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