THE ETHICAL IMPLICATIONS OF MODERN TECHNOLOGY FOR THE PHYSICAL THERAPIST Registrant Information: Name: __________________________________________________________________ Address: ________________________________________________________________ Phone: __________________________________________________________________ Email: __________________________________________________________________ Discipline: ________________________License #: ______________________________ Company: _______________________________________________________________ Date/Location: ___ Tues. May 12, 2015: 6:00 – 8:45 pm – Hilton Garden Inn, 800 US Highway 130, Hamilton, NJ 08690 ___ Wed. July 1, 2015: 6:00 – 8:45 pm – Wyndham Hotel, 1111 Route 73 North, Mount Laurel, NJ 08054 Course Fee: Single $69 Payment: Easy registration online at www.myskillsfirst.com or by Check or Credit Card must accompany registration by mail Total: $________ ______ Check (payable to Skills First) ______ Visa ______ Mastercard ______ Discover ______ American Express Cardholder’s Name: _______________________________________________________ Card #: _________________________________________________________________ Expiration Date: ________________________Security Code: ______________________ Authorized Signature: ______________________________________________________ Substitution and Cancellation Policy: Requests for cancellation must be received in writing by fax or mail ten (10) days prior to the seminar in order to receive a refund less a $20.00 administrative charge per canceled attendee. If the cancellation is made within ten days or less, refunds will not be granted for any reason. A credit voucher will be issued that may be used toward a future course. Credit vouchers are transferable and do not expire. If we must cancel or change the course for any reason, our liability is limited to the cost of tuition. If you register and do not attend, you are still responsible for payment. THE ETHICAL IMPLICATIONS OF MODERN TECHNOLOGY FOR THE PHYSICAL THERAPIST (2.5 CONTACT HOURS) Pending approval by NJ and PA Physical Therapy Board Course Description: This two and a half hour course covers explores ethical and legal issues that arise due to the use of modern technology by the practicing physical therapist. Participants will have the opportunity to discuss real life clinical examples and identify potential ethical concerns with instructor and peers. Specific topics to be addressed include the electronic medical record, Social Media such as Facebook, Linked in and Twitter and clinical usage of application based hand held devices. Course Objectives: Upon completion of the course, the participant will be able to:  Discuss current forms of technology in daily clinical practice  Identify ethical and professional duties related to technology usage  Identify types and sources of law governing technology usage Course Fee: $69 Course Dates / Locations: Registration begins a half hour prior to start time Tuesday May 12, 2015: 6:00 – 8:45 pm Hilton Garden Inn, 800 US Highway 130, Hamilton, NJ 08690 Wednesday. July 1, 2015: 6:00 – 8:45 pm Wyndham Hotel, 1111 Route 73 North. Mount Laurel, NJ 08054 Course Schedule: Registration begins a half hour prior to start time  Course is organized into 8 individual cases/topics, one for each principle of the APTA Code of Ethics for the Physical Therapist. First 15 minutes: Overview/Basic introduction to ethics of technology 2 hours: 15 minutes will be dedicated to each principle and related example Last 15 minutes: Wrap up/Question and Answer Course Instructor: BRIGETTE CUFFIA PT, JD has been a licensed physical therapist since 1995. Her clinical background is primarily in neurological rehabilitation and community health. She has been the ACCE at Neumann University in the DPT program since 2001. At Neumann she teaches Health Policy, Values and Ethics and Education and Consultation within Physical Therapy Practice. Ms. Cuffia is also a PA licensed attorney having earned her law degree from Temple University in 2006.