Alumni Survey

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      UNIVERSITY OF MARYLAND EASTERN SHORE
    DEPARTMENT OF PHYSICAL THERAPY

    ALUMNI SURVEY 

    You have the option to remain anonymous (if this option is chosen, please place an “X” in the required field). 

    Name:  
       
    Phone:  
       
    Email:  

    I.      BACKGROUND INFORMATION
    A.     In what year did you graduate from the University of Maryland Eastern Shore?
             

    B.     In which of the following physical therapy settings have you been employed since graduation?  (check all that apply)
             Type of Facility
                    


    C.     Please provide the following information on your first and present employment situations:

    1.  First Position:
         Location: City  State 

        Setting:
                    

     
                    

    2.  Present Position:
         Location: City  State 

        Setting:
                    

     
                    

     
                    

    3.  Have any of your positions been in management/administration?
                    
    If yes, for how many years? 

    If yes, please describe your position  

    II.     GENERAL INFORMATION:
    A.     Are you satisfied with your current abilities to examine, evaluate, and devise plans of care for patients/clients?
                    

    B.     Are you satisfied with your contributions to society through your physical therapy practice and other professional activities?
                    

    C.     Are you currently a member of the American Physical Therapy Association (A.P.T.A.)?
                    

    D.     Are you currently a member of any other professional organizations related to physical therapy?
                    

    If yes: Please identify the organization 

    E.     Have you served on committees or as an officer for the A.P.T.A. at the regional, state and/or national level?
                    

    If yes: Please describe 

    F.     Are you currently an American Board of Physical Therapy Certified Clinical Specialist?
                    

    If yes, in which specialty area? 

    G.     Have you received any awards, special recognition, specialized training, and/or certifications?
                    

    If yes, please describe: 

    H.     Have you been a Clinical Instructor for physical therapy or physical therapist assistant students?
                    

    If yes:  Number of P.T. students  Number of P.T.A. students

    I.     Are you an A.P.T.A. Credentialed Clinical Instructor?
                    

    If yes:  Date of training

    J.     Have you been involved in presenting workshops, lectures, seminars, or in-service presentations for any of the following groups?
                    

    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?
                    

    L.     Have you participated in any clinical research projects since graduation from UMES?
                    

    If yes, please describe research projects, publications, presentations:


    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?
                    

    If yes, please describe 

    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?
                    

    If yes, please describe 

    O.     Please provide any comments that you would like to express regarding areas that have not been addressed in this survey.