Document 6565815

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Advancing Occupational Therapy 2014
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Competent Clinical Practice Research and Development Political Advocacy
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North Carolina Occupational Therapy Association!
Annual Conference October 18-19, 2014!
Novant Health Conference Center Winston-Salem
North Carolina Occupational Therapy Association
PO Box 20432 Raleigh NC 27619
www.ncota.org office@ncota.org 919-785-9700
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Welcome to the 2014 NCOTA Annual Fall Conference.
This year we have some exciting changes and additions. The Keynote presentation
on Saturday and the Capstone Address on Sunday should be inspiring to OT
practitioners in all areas of practice. There will be 6 breakout sessions with
workshops available in several tracks: Pediatrics, General, Physical Disabilities,
Mental Health, and Assistive Technology. Our Special Interest Section (SIS) Sessions
have expanded to 75 minutes so you have more opportunity to meet and network
with other people in your practice area, and discuss a key issue facilitated by the SIS
Chairperson. Altogether, there is the opportunity for 13.25 hours of continuing
education credit, which nearly satisfies the license renewal requirement. Join us also
on Saturday evening for socializing, refreshments, and the Silent Auction, which will
help raise money for the NCOTA Scholarship Fund. In addition there will be a raffle,
with prizes awarded on Sunday during the NCOTA Annual Business Meeting and
Awards Luncheon. Once again, parking and lunch are included in your registration
fee.
Brenda Kennell, OTR/L
Nancy Murphy, OTR/L
NCOTA Continuing Education Co-Chairpersons
Professional Development/Educational Program
• Educational sessions include clinical knowledge and skills, career development, and other topics related
to 7 Special Interest Sections.
• Earn 13.25 contact hours of CE credit from a single conference registration,
• Continuing competency: All professional development programs offered by NCOTA are pre-approved for
continuing competency credit by the North Carolina Board of Occupational Therapy (NCBOT). An NCOTA
certificate of attendance detailing sessions/hours accrued will be issued to registered attendees. Attendance will
be recorded at each session.
NCOTA Members receive a substantially discounted rate on conference attendance. If you want to join to
receive the member registration rate, go to the website: www.ncota.org and join online OR download a membership
form and submit with your registration OR complete the membership application on the back of the registration
page. If you pay by check, submit 2 separate checks̶one for registration and one for membership.
Registration Policies: (check dates on registration page for early discount, regular rate, and important deadlines)
• Online registration will be available on the NCOTA website! www.ncota.org
• Registration status will be verified with the membership database. If you register as a member and your
membership status is not current, you must join or pay the difference (non-member rate) in order to attend.
• All registrations received by October 12th will receive a confirmation email prior to conference. If you do not
receive a confirmation email by then and want one, contact the NCOTA office.
• Full refund less $25 administrative fee will be given if notification of cancellation is received by October 12,
2014. After that date, no refunds are permitted, but you may substitute another person to use the registration.
• No faxed or mailed registrations will be accepted after October 12th. Online registration will not be available
after that date.
• Onsite registration is available. There is a $20.00 fee in addition to the regular registration rate.
Reasonable Accommodations
Attach a letter with a detailed description of your needs and submit with your registration.
!
Lodging: Information on local hotels will be posted on the website. If you want to do
your own search, the address is 3333 Silas Creek Parkway, Winston-Salem, NC 27103
Book your room early since this is homecoming weekend for Winston-Salem State.
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Contact NCOTA at admin@ncota.org
919-785-9700
Fax 919-771-0115
Saturday October 18, 2014
7:30
Registration Desk Open
8:15-9:30
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9:30
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Welcome, Conference Overview
Important Updates from NCBOT, AOTA and WFOT
Break
Keynote Address
9:45-11:45
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Take Care of Yourself First: Three Lessons in Self Care from a Long-Distance Motorcyclist
Tamela Rich, Award Winning Author and Speaker
Tamela has traveled across North America on a motorcycle, searching for life lessons from people facing
health crises: patients, caregivers, friends and family members. She collected their wisdom in her awardwinning book, Live Full Throttle: Life Lessons From Friends Who Faced Cancer. Tamela will share three of
these lessons that occupational therapists can directly apply to their lives, helping them embrace the
importance of self-care for the sake of their loved ones, the clients they serve, and ultimately themselves.
!
11:45-1:45
!!
Lunch (included with registration)
Visit with exhibitors, review posters, view silent auction items.
1:45-3:30
1A
Successful Psychosocial Group Interventions: Strategies Styles and Content
Deborah Dunn, BS, OT/L, Julie Toporek, MS, OTR/L, Lindsey Ellington, MS, OTR/L,
Jacqueline Allotey, MS, OTR/L, Caity Bunch, MS, OTR/L, Stephanie Ready, OTS
This session will focus on types of group interventions utilized with clients who have psychosocial needs, utilization of the
therapeutic self to make a critical difference in the efficacy of your interventions and how to manage disruptive behavior in
a group setting. Examples of groups will be discussed and how to modify to capitalize the client's strengths and interests
in order to change the groups dynamic balance. Types of groups cover the range from health & wellness, recovery, social,
coping and community life skills. MH
!
1B
Keeping the PACE: The PACE Model Facilitates Productive Aging in Place
Cathrine Balentine, MS, OTR/L, James Proctor, OTS
As the older adult population in the U.S. grows rapidly, so do their healthcare needs Furthermore, as the country faces
problems associated with demands on the healthcare system, it becomes crucial to embrace innovative solutions to
address these challenges. This session is designed to enhance your understanding of one of these innovative solutions,
the Program for All-Inclusive Care for the Elderly (PACE); this model of care will provide the context to explore concepts
of aging in place and productive aging. Attendants will learn about the ever evolving role of OT within one North Carolina
Program, as the PACE team works to improve its ability to fulfill its mission to support frail older adults to remain safely in
the community with the highest quality of life possible. GERI/PD
!1C
Pediatric Power Mobility, Assessment and Access
Tony Leo, MOT, OTR/L, ATP
This presentation is designed for OTs/OTAs working with pediatric populations. It is centered on how to assess / evaluate
clients for power mobility devices. It covers the importance of early mobility, examines current pediatric power wheechairs,
access methods and examples. PED/AT
!1D
Enacting the Centennial Vision: Bridging the Gap between Students and Practitioners as
Emerging Leaders
David Benthall, MS, OTR/L, QDCS, Christine Gunnigle, MS, OTR/L, Stacy Wilson, MS, OTR/L,
Amy Mahle, MHA, COTA/L
As the realization of the Centennial Vision approaches, there has never been a better time for new practitioners to engage
in leadership opportunities within the OT profession. This short course is designed for OT/OTA students and new OT
practitioners to identify supports and barriers to their personal leadership capacity, as well as strategies to embrace
emerging leadership opportunities on a personal, local, and global level. Participants will be inspired by stories of active
leadership from a panel of occupational therapy practitioners who have embraced early leadership opportunities in the
profession. This interaction session will also illustrate how to become involved in leadership activities as an early OT
practitioner, as well as ignite your passion to serve, grow, and develop your leadership story. GENERAL
!!
1E
Rehab Stroke Standards of Care- Process and Updates in a Comprehensive Stroke Center
Sanchala Sen, MS, OTR/L, BCPR
This workshop will describe in detail the process and subsequent updates in formulating and implementing the
rehab stroke standards of care in a comprehensive stroke center in NC. It will highlight the changes made on an
ongoing basis based on the deficits identified and areas of education needed by therapists working on the acute
stroke unit, especially in areas of cognition and vision. It will benefit attendees who wish to learn more about specific
stroke care both in areas of assessment and intervention. PD/GENERAL
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1F
Item Writing Workshop: Tips and Strategies for Writing Multiple Choice Questions (Ed)
Denise Donica, DHSc, OTR/L, BCP
Testing the knowledge of others is a skill. One approach often used in testing others is multiple choice question
exams and quizzes. This workshop will provide tips and strategies for writing good multiple choice questions
combined with opportunities to apply these skills within the session. All material was developed by the National
Board for Certification in Occupational Therapy and NBCOT retains the ownership of all workshop materials.
!3:30 Break
3:45-5:30
Psychological Consequences of Stroke for Survivors and Caregivers: Assessment and
Intervention
Mary Hildebrand, OTD, OTR/L
There are about 6.8 million Americans who have had a stroke and 795,000 persons who experience a stroke
each year. Up to 50% of stroke survivors may experience stroke-related psychological or emotional disorders
such as depression or anxiety. However, many OTs focus solely on the physical impairments of stroke even
though psychological conditions have a significant negative effect on the stroke survivor’s overall health
outcomes. Psychological assessments and interventions for the stroke survivor will be discussed.
Additionally, stroke rehabilitation guidelines state that the caregiver is the most important environmental factor
for the stroke survivor. Evidence-based caregiver assessment and a caregiver treatment framework, “Timing
It Right”, will be discussed. MH
2A!
!3:45-6:30
(Two successive workshops in one room.)
2B-1
It’s A Man’s World Too! Gender Bias in Occupational Performance Activities (1.75 hrs) !
Susan Blair, OTR/L, BCPR
The lack of gender specific interventions for male patients is evident in the scarcity in availability of
appropriate occupational performance activities in inpatient rehabilitation centers. This may lead to a
decline in male role delineation; psychosocial well being and gender de-affirmation as population ages and
skews to a higher female ratio. This presentation discusses gender-based research; provides examples of
gender-bias free evaluation tools and demonstrates gender appropriate interventions, which meet the
functional occupational performance needs of male patients in today’s rehab environment. GERI/PD
!2B-2
Turner Syndrome and Beyond: Living Life to the Fullest (1 hr)
Megan Edwards, PhD, OTR/L
The current study explored the lived experience of women who have Turner Syndrome. Twelve adults
with Turner Syndrome were interviewed to research the impact Turner Syndrome has had on their daily
life and the lives of their family members. In general, participants felt that they grew up like “normal”
children. They emphasized that those with Turner Syndrome can lead happy, healthy lives, and offered
advice for family members impacted by Turner Syndrome. This included not letting the label of “Turner
Syndrome” hinder them from seeking their dreams, and utilizing resources from the Turner Syndrome
Society. Participants also had recommendations for healthcare professionals, such as becoming
educated on Turner Syndrome and providing families with resources. Findings will be related to other
diagnoses and to occupational therapy. GERI/PD
(Two successive workshops in one room.)
2C-1 Assistive Technology Devices and Strategies for Persons with Low Vision
Jennifer Radloff, OTD, OTR/L, CDRS Leonard Trujillo, PhD, OTR/L, FAOTA
The purpose of the session is to enhance the OT practitioners understanding of available assistive technology
devices and compensatory strategies that can be used with persons that have low or impaired vision.
Participants will have the opportunity to experience various magnification devices and visual enhancement
viewers. In addition, Windows and Mac built-in accessibility features and options will be demonstrated. The
session will include discussions of how the technology and strategies can improve occupational performance
for persons with low or impaired vision. AT
3:45-6:30 (cont’d)
2C-2
Phone Zone: For People with Speech Disabilities
Joan Black
In today’s world all people, with disabilities or without, must be able to communicate with others over the
telephone (landline, cell, or IPAD) at home, office or out and about. The Relay North Carolina Speech to
Speech Service provides telephone accessibility, at no charge, for people with speech difficulties;
occupational therapists will be able to encourage their patients to get back on the phone for independence,
security and better quality of life as well as how to access their own services of information and support. AT
!
2D!
Mobilizing the Morbidly Obese Patient: An Interdisciplinary Approach
Anne Kelly, OTR/L, BCPR Andrew George, PT, DPT, MPH
Our presentation will help prepare clinicians to care for the medically complex bariatric patient. This program
was developed through interdisciplinary work between Duke University Hospital OT/PT Division, Duke
University DPT Program, Duke School of Nursing, and Duke Ergonomics Department. Our program will
examine the medical complexities that impact therapeutic intervention and must be considered when
preparing to mobilize the patient population. We will also review assessment and interventions to improve
functional mobility and completion of activities of daily living. GENERAL
!(Two successive workshops in one room)
2E-1
The Role of Occupational Therapy with Clients with ALS / MND (1.4 hrs)
Francesca Monachino, OTR/L Melissa Uhl, OTD, OTR/L
Amyotrophic lateral sclerosis (ALS) is a progressive disease which presents with Lower Motor Neuron signs
with focal onset of weakness or initial Upper Motor Neuron symptoms of jerking or stiffness. Clients are
followed on a regular basis by OT at the Duke ALS Clinic. ADLs are reviewed. Adaptive devices, splinting,
DME options are discussed. Problem solving skills and family training are addressed. The OT screens for
driving safety. Clients struggle with the progression of impairment and accepting our recommendations. We
may determine that a comprehensive OT driving evaluation and “Behind the Wheel“ test are warranted.
PD/GEN
2E-2
!Best Practices for Oncology Rehabilitation (1.4 hrs)
Sarah Sangermann, MS, OTR/L
Brittany Lorden, OTR/L
Lisa Malec, OTR/L, CLT-LANA
Oncology Rehabilitation is an evolving specialty within the rehabilitation world. Individuals with cancer
diagnoses require both specialized and integrated care, focused on the whole person and support
system. With the newly developed Commission on Accreditation of Rehabilitation Facility standards
for cancer rehabilitation, there is a significant focus on the delivery of cancer care. This session will
focus on assessment, goal setting, treatment, discharge planning and coordination of care for
individuals with cancer as it relates to the preventative, restorative, supportive, and palliative phases
of rehabilitation care. PD/GEN
!!
2F
Transitioning to Teaching: It’s More (and Less) than Power Point Lectures!
Beth Fain, OTR/L Brenda Kennell, OTR/L
Baby Boomers make up the majority of the population in the academic settings and will be retiring soon. For
OT practitioners interested in moving into education, now is a prime time to explore and engage in teaching
the future practitioners. The increasing demands for faculty and the increasing educational opportunities for
OT Clinicians are exploding. In this workshop, we will explore the similarities and differences of clinical
practice and teaching, discuss opportunities to teach and learn how accessible it is to teach. We will then
use this information to develop a teaching professional development plan and teaching opportunities with
an OT/OTA program including the use of technology. This workshop will be highly interactive. Ed
!_____________________________________________________________________________________
!
5:30-7:30 Evening Reception and Silent Auction
At the end of a busy day, please join us for our Evening Reception and Student Scholarship Auction.
Meet Board members and your SIS Chairs or just hang out with friends. Enjoy a variety of hors d’oeuvres
and refreshments. Funds from the auction contribute to NCOTA sponsored scholarships. The auction will
end at 7:00.
!
Sunday Program October 19, 2014
!
8:00 Registration Opens
!
8:30–9:45 SIS Networking Sessions
Group
Facilitator
Topic
A
Administration
Page Riggs
Leading Through Change
B
Assistive
Technology
Amber Ward
AT Options for Persons with Progressive Disorders
C
Pediatrics
Alisha Baker
Kristin Burgess
Discussion and problem solving among school based and
outpatient pediatric therapists to begin to create a framework for
collaboration.
D
Home Health
Mary Hildebrand
AARP’s "Home Fit” Program: Helping Older Adults to Safely Agein-Place
E
Mental Health
Allison Taylor
Review of Evidenced-Based Practices in Psychosocial Practice
and Community Based Opportunities
F
OT Educators
Amy Mahle
Megan Edwards
Building an OT Fieldwork Consortium
G
Gerontology
David Benthall
OT & End-of-Life Care: Optimizing Quality of Life through
Meaningful Occupation
H
Physical
Disabilities
Sanchala Sen
Commonly Used Standardized Assessments in Acute and
Inpatient Rehab and Their Validity
I
Private Practice
Beth Hathaway
How to Use the Internet to Build Your Practice
!Break 9:45-10:00
!10:00-11:45
3A
Evaluations and Collaboration: Utilizing Our Role Effectively in Mental Health
Valerie Fox, OTR/L, CPRP Caity Bunch, OTR/L
This presentation will explore the role of OTs on interdisciplinary mental health teams, including how our
evaluations and assessment findings can inform interdisciplinary treatment planning and enhance
collaboration between disciplines. We will review frequently-used inpatient mental health evaluations,
advocacy approaches, and common occupational issues found on inpatient mental health units. We will focus
on occupational deprivation as one specific area that OTs are primed to address on inpatient mental health
units and how we can best advocate and share the importance of our evaluation. MH
!3B
Using Therapeutic Gardening to Facilitate Optimal Patient Outcomes
Twylla Kirchen, PhD, OTR/L
This presentation will describe how one Veteran’s Home in NC transformed a forgotten outdoor area into an
amazing garden environment that enhanced quality of life for patients, families and staff. An interdisciplinary
therapy team embedded traditional rehabilitation goals into planning, planting, caring for, harvesting and
cooking vegetables from numerous garden beds. The OT patients did not refuse therapy, reported feeling
happier and healthier and met outcomes when or before expected. The presentation will provide a photo
documented process of initiating a therapeutic garden, describe how to embed goals into gardening
activities, discuss ways to adapt garden activities to allow for maximum patient participation and discuss
precautions involved with using therapeutic gardening. GERI/PD
3C
Set Your Sights High: Discover Visual Rehabilitation in Pediatrics!
Michelle Yoder, OTR/L, CIMI Steven Haleo OD, FCOVD
This workshop is designed to help OTs understand and identify visual challenges in the pediatric
population and implement treatment strategies to improve performance at school, at home, in sports and
leisure activities. We will explore the anatomy of the eye and visual system and learn specific visual skills
needed for reading, writing and learning. Participants will learn brief screening methods to identify visual
challenges and through interactive labs, learn treatment techniques to help the following areas: eye
teaming and tracking, eye-hand coordination, visual motor integration and visual perception. PEDS/AT
3D
Happiness: How to Apply this to Our Practice?
Anne Fleischer, OT/L, CLT-LANA
This session will explore various theories of happiness. Connections will be drawn between these
theories and OT models. Case studies will be presented differentiating between “experiencing self”
versus the “remembering self” of patients who have experienced happiness. Discussions will center
around how theories of happiness can be applied to OT practice. GENERAL
!!
3E
Assessing Apraxia: Functional Measurement and Appropriate Intervention in Neuro
Rehabilitation.
Melissa Moser, MS, OTR/L
Kirsten Brown, DPT
Assessment and intervention of motor apraxia in the neurological rehabilitation population is complex in
nature. The Occupational Therapist is uniquely qualified to evaluate and treat this often neglected aspect of
neurological impairment. However, many therapists are uncomfortable in their clinical skills for addressing
this deficit due in part to a lack of knowledge about appropriate measurement tools and process
intervention. Historically, assessment is generally focused on elimination of other factors such as cognition,
perception, tone and aphasia. In turn, interventional methods may be less effective and inadequate in
improving the client’s occupational performance. This presentation will provide clarification of current
research, discussion of formal evidence based assessment tools and demonstration of occupation based
interventional methods easily incorporated into today’s clinical environment. PD/GEN
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3F
Unique Fieldwork Collaboration to Help Prepare Students for New Healthcare Systems
Cathy Schweiker, MS, OTR/L Allison Bolin, MS, OTR/L Michele Redderson, MS, OTR/L
As experienced clinicians we must provide opportunities for students to attain the skills needed to adapt to the
many changes in the healthcare field. New graduates need to have the ability to articulate what OT is but also be
able to describe what OT can accomplish in a variety of settings. Fieldwork educators and clinical instructors
must adapt to a new reality of OT practice within changing healthcare environments. We will share how
collaborative restructuring of the learning opportunities in two traditional fieldwork sites can prepare future
practitioners to adapt to the new realities of OT practice along the continuum of care. We will provided examples
and we will outline how CIs can collaborate & structure a Level II student’s learning to optimize the student’s
learning opportunities in order to become a more well-rounded entry level practitioner. Ed
11:45-1:30
Annual Business Meeting and Awards Lunch
Included with your registration. Help us recognize the exceptional work of your colleagues.
!
!
1:30-3:15
4A
Initiation and Collaboration of OT and RT Programming in Psychiatry
Shelley Sehorn, OTR/L Jayme Kirk, OTR/L
Brittany Robertson, OTR/L
This session will focus on the OT program at Wakebrook, a new psychiatric campus owned and operated by UNC Health
Care. Program development of OT services on the inpatient psychiatric unit will be discussed. This facility also provides
RT services on the inpatient unit and, given the overlap of scopes of practice with both therapies, a division of patient
services was vital for the sustainability of both. This session, which include both OT and RT presenters, will review both
the scopes of practice and explore this overlap, as well as how collaboration and utilization of both services are crucial in
mental health practice. MH
!4B
A Framework for Generalists to Identify Safety Risk and the Pathways for Addressing Driving
as a Valued IADL.
Anne Dickerson, PhD, OTR/L, FAOTA
Driving is a highly valued IADL for those who want to return to driving or learn to drive. Thus, it should be
addressed by all OTs to determine safety risk, potential for learning or returning to driving, and when to refer
to a specialist. This session will introduce a framework for generalists to use for determining risk and when
to refer to a specialist, allowing all clients to have driving be part of their evaluation or intervention plan.
GERI/PD
!
Implementing Alert Program in K-2nd Grades: What We’ve Learned
Carol A. Lust EdD, OTR/L & Monica Powell MSOT, OTR/L
This 2 hour short course will present how the Alert Program was implemented to all students in a
kindergarten setting for four years. A chronicle of the changes made to the program will be discussed based
on what was learned from evidenced based literature, pre-test and post-test findings, input from the Alert
Team members, plus informal feedback from the teachers and students. Different program formats used
along with the sensorimotor equipment and materials the students enjoyed will be shared and different ways
to track students’ performance. The presenters will also discuss the 6-8 week follow-up intervention
program used for selected students at risk in the first and second grades and how it provided more student
choice, control and sensory opportunities. PEDS
4C
!4D
Patients: Factors that Drive Their and Our Behaviors
Caroline Berry, OTR/L
This is a refresher course regarding illness/disability and recovery. Applies to many settings, but created
especially for adult rehabilitation. We sometimes forget / tend to downplay the baggage that accumulates
when recovering from illness / injury. This course is designed to refresh and recharge our understanding of
patients as they recover and what strategies we can employ to help them. GENERAL
!4E
Implementation Science: A Guide for Moving Practitioners and Programs Forward
Lauren Holahan, MSOT, PhD Candidate, OTR/L Laurie Ray, MPT, PhD
Perry Flynn, MEd, CCC-SLP, AP
This interactive workshop will equip participants with strategies for aligning therapists’ clinical reasoning and
practice behaviors with institutional /agency / business goals, evidence, practice standards, and regulatory
requirements. NC Dept. of Public Instruction Consultants in OT, PT and Speech will work from an
implementation science framework, as well as their own experiences in effecting practice change from the
state level, to explore with participants how to: lead therapists toward provision of mission-relevant services,
keep pace with best practices and effect sustainable improvement in therapy programs. Participants will
analyze their own practice situation, select a strategy and develop at least one plan for implementing change
in a program or area of practice within the scope of their control. PD/GENERAL
4F
Thrive (Not Just Survive) During Fieldwork
Amy Mahle, MHA, COTA/L Christa Gaille-Weiss, MS, OTR/L, CAPS
In this session the presenters will identify professional behaviors needed for successful fieldwork experiences,
summarize communication strategies for conflict resolution, and compare experiences of successful OT and
OTA graduates via a panel discussion. Ed
!!
3:15-3:30 Break
!3:30-5:30 Capstone Address:
Advancing Occupational Therapy: The Evolution of the Occupational Therapy Practice
Framework
Debbie Amini, EdD, OTR/L, CHT, FAOTA
The Occupational Therapy Practice Framework: Domain and Process, provides a generic outline of the
profession’s unique domain of concern and outlines a process that explains how occupational therapy service
delivery occurs within this domain. This document has been instrumental in guiding practitioners to clearly
focus their practice on assisting others to attain, regain, or maintain their ability to participate in daily life
activities. This presentation will highlight revisions from the recently completed 3rd edition of Framework and
discuss application to various areas of practice and settings.
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NCOTA was founded in 1957. For 57 years this volunteer-run and supported association has
been the primary statewide voice for the practice of occupational therapy in NC. The association
organized and led the successful effort to obtain licensure in 1984. The list of licensed
practitioners in NC has grown from a few hundred to over 4600. !
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In recent years our efforts have expanded from enhancing competent practice and
facilitating community to actively protecting the profession. Our lobbyist, Ashley
Perkinson, has been working with the current Board during challenging times
when employment and reimbursement seem under constant threat. !
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As always, there is strength in numbers. If you are not a member, we hope you will join to add
your support. A primary benefit of membership is the feeling and knowledge that you are making
a positive contribution toward the advocacy of our profession and the future vision of the
association. It is easy to do now online. Secure and easy. Just go to www.ncota.org and take
a look around. Sign up or renew your existing membership today.
Other News!
Ethics!
Beginning with this licensure year (ends May 31, 2015) you are required to have one hour of
ethics training annually. As is our tradition, NCOTA will hold one or two regional continuing
education events next spring and ethics will be included in both. Date and locations are being
organized now.!
!
Website!
We are working on a brand new custom website. We hope it goes live soon. We think you will
like it. There will be a few changes of course, including an improved member section.
Instructions will be sent to active members on how to set up your log-in and profile.!
NCOTA 2014 Annual Conference Registration !
(online registration and payment available: www.ncota.org)
Name: _______________________________ OT __ OTA __ OTS __ OTAS __!
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Address ___________________________________________ City __________________ Zip ______________!
Preferred Phone ____________________________ Email address ________________________________________!
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(must be legible)!
Active Member Yes ____ No ____ (to join or renew and receive member discount, form is on back or online)
1. Keynote Address Saturday am ___
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2. Saturday Workshops !
1A __
1B __
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2A __
2B (1 & 2) __
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1C __
1D __ 1E __ 1F __ !
2C (1 & 2) __
2D __ 2E (1 & 2)__ 2F __!
3. I will ___ will not ___ attend the Reception Saturday evening!
4. Preferred SIS Meeting (Sunday am) (circle choice) A
B
C
D
E
F
G
H
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5. Sunday Workshops 3A __ 3B__ 3C __ 3D__ 3E __ 3F __ 4A __ 4B __ 4C __ 4D __ 4E __ 4F __!
6. Capstone Address Sunday pm ___!
OT/OTA
Member
$185.00
Student
Member
$65.00
OT/OTA
Non-member
$235.00
Student Non-member
$100.00
One day - Early (received by 9/15)
Check day __ Saturday __ Sunday
$130.00
$45.00
$170.00
$75.00
Full conference Sat-Sun - Regular
(received by 10/12)
$195.00
$70.00
$250.00
$110.00
One day - Regular (received by 10/12)
Check day: __ Saturday __Sunday
$140.00
$55.00
$180.00
$80.00
Full conference Sat-Sun - Early
(received by 9/15)
No pre-registrations accepted after October 12
Onsite available. Add $20
Speaker Discount is 25% (Fee x .75)
Payment: (to join or renew and receive member discount, form is included on back of this page or online)!
___ I am paying by check, payable to NCOTA!
___ I am paying by credit card. Card number: ___________
___________
___________
___________
Card expires: Month:_____ Year: _____ Security code: (3 digits on back of card after card number:) ___
Name as it appears on card: ______________________________________________
I authorize NCOTA to charge my credit card: $ __________ (email receipt will be sent to address provided at top of page)!
MAIL your registration to: NCOTA, PO Box 20432, Raleigh, NC 27619 OR FAX your registration to:
919-771-0115 or register ONLINE (by credit card) at: www.ncota.org NCOTA voice mail 919-785-9700!
2014 Membership Application - Join Online at www.ncota.org
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PO Box 20432 Raleigh, NC 27619 919-785-9700 office@ncota.org
Name ____________________________________
__ OT __OTA __ OTS __ OTAS!
Address _________________________________City _______________
State ____
Zip _________!
Preferred Phone ____________________ Email (legibly please!)_________________________________________!
Employer / School _____________________________Address _______________________________________!
City________________________
State ____
Zip _____________!
Work Setting: __Academic __Early Intervention __Home Health __Schools __Hospital __Private Practice
__Outpatient Rehab __Mental Health Setting __Skilled Nursing / LTC __Other _____________!
Special Interest __ Administration / Management __ Gerontology __ Pediatrics __ Mental Health __ Home Health !
__ Physical Disabilities __Technology __ Developmental Disabilities __ Other _________________!
Membership Fee:
OT $75
OTA $65 New Therapist (first year) $45
Mail payment:
__ By check. Make payable to NCOTA!
__ By credit card
Acct #_____
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OTS / OTAS $45!
______ Exp. Date _____ Security Code ____!
Name on card _______________________________ Signature ___________________________!
Information is secured until processed and then shredded. To protect privacy we do not keep personal account information. An
automated receipt will be sent to your registered email.!
NCOTA!
PO Box 20432!
Raleigh, NC 27619