NABPT CLINICAL INSTRUCTOR DIRECTORY
The NABPT Clinical Instructor Directory will be solely utilized as a resource to connect PT students with clinical instructors identifying as persons of color.
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Full Name (First, Last) *
Email *
Telephone number (no dashes) *
Degree *
Required
Which educational program did you attend? *
Are you currently an APTA Certified Clinical Instructor? *
Required
Do you agree to be entered into the NABPT Clinical Instructor Directory? *
Required
What City and State do you currently practice in?

 *
What clinical setting do you currently practice in (Ortho, Peds, Acute rehab, Neuro, etc)? *
ABPTS Specialties *
Required
Are you currently taking students? *
Are you an SCCE (Site Coordinator of Clinical Education) OR  Do you have direct contact with an SCCE? *
Do you have direct contact with an SCCE at an institution or work place?   *
Please name and list SCCE contact information (if applicable) *
May we contact you via email for any further information required for the purpose of the NABPT Clinical Directory? *
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