CAPM&R Core or More SIG Application Form

Chair Pediatric Special Interest Group

The CAPM&R Pediatric Special Interest Group is seeking individuals interested in taking the role as Chair of this important Core SIG.

The Terms of Reference is available here.

1. Demographic information

Name (First and last name)
Email
Geographic Location

2. Select you Membership Type. *This question is required.

3. Name of the proposed SIG

4. The current active member interested in leading this SIG is:

5. Tell us why this person should be the chair. 200 words

6. The current active members of CAPM&R interested in participating in this SIG include:

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7. Purpose of the proposed SIG

8. List at least 3 goals of the proposed SIG.Sample goals include:

Promote the most effective and evidence-based treatment for people experiencing _______
Increase awareness of the role of rehabilitation and the management of ___________
Increase awareness in the needs to improve patient outcomes and outcome measures in patients with _____________
Promote quality improvement approaches in _______________ care
Spread awareness of relevant research updates in ______________
Promote education of trainees and practitioners in _____________
Disseminate updates and new information and treatment
Promote improved practices
Disseminate research by members
Promote a quality improvement approach to care which will ultimately improve patient outcomes

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