NOTA Practitioner of the Year 2018
This award recognizes an occupational therapist or occupational therapy assistant who demonstrates responsibility, leadership, enthusiasm, and creativity in the practice of occupational therapy in Nebraska.

This award is not for years of service, but for quality, proficiency and contributions. This award may be granted to the same individual more than once.

Please provide the name of the person you are nominating for NOTA Practitioner of the Year. *
Your answer
Please provide contact information for the person you are nominating including address, email, and phone number. *
Your answer
Where is the nominee currently employed? *
Your answer
To the best of your knowledge, does the nominee meet the following requirements: •Current member in good standing of NOTA • Licensed to practice OT in the state of Nebraska • Minimum of three years of clinical experience *
Qualifications-Part I: Does the nominee qualify for clinical expertise in all of the following areas? 1. Recognized as a resource person and knowledgeable of OT principles and practice 2. Solves a variety of clinical problems 3. Sees short-term and long-term needs of clients 4. Articulates OT to consumers and other healthcare professionals 5. Held in high esteem *
Your answer
Qualification--Part II: Please describe how the nominee qualifies in at least one of the following related activities: 1. Shares knowledge through workshops, articles, consulting, clinical teaching 2. Research 3. Outstanding leadership, staff or program development. *
Your answer
Please provide your name and contact information. *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms