Advanced Proficiency Pathway Worksheet
Applicant Name:
APP in (content area):
Date of Review
Contact E-Mail:
Contact Phone:
Requirement
Contact
Hours
Date
Completed
Comments
Continuing Education – APTA Core Courses
If substitute courses are accepted, please use the Comment area to document course title, course provider, year completed,
contact hours in APP content area.
 The Future of Health Care Reform
 Defensible Documentation
 Health and Wellness for the Older Adult:
Roles, Responsibilities, and Evidence
for PT Practice
 The International Classification of Function
 Leading the Team: A Practical Guide to
Working with PTAs
 Bridging to Best Practice: Translating
Evidence to Improve Efficiency,
Effectiveness, and Marketability
 Translating Evidence to Practice
 Values-Based Behaviors

Safe Patient Handling and Movement:
Guidelines for Healthcare Workers
Continuing Education – Content Specific Courses
If substitute courses are accepted, please use the Comment area to document course title, course provider, year completed,
contact hours in APP content area.
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Total Continuing Education Contact Hours
(60 hours required)
Clinical Hours in Content Area (2000 hours required)
 Clinical hours confirmed by supervising
physical therapist
Competency-Based Assessment
 Completion of Skills Rubric confirmed by
clinical mentor
Additional Comments:
Date of Completion:
Program Mentor:
Date:
 Return completed form to e-mail [email protected] or FAX: 703.706.3387.
 Revised 4/1/14