World Physiotherapy CPD event recognition service

Peer reviewer application form

Thank you for your interest in becoming a volunteer peer reviewer for the World Physiotherapy CPD event recognition service. Please complete this short survey.

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* 1. First name

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* 2. Last name

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* 3. Email

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* 4. Are you a registered physiotherapist?

Yes

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* 5. Registration

Enter the name of the licensing agency

Enter your registration number

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* 6. Are you a member of a World Physiotherapy member organisation in your country/territory?

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* 7. Membership number

Enter your membership number for the national physiotherapy association in your country/territory

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* 8. Please select the World Physiotherapy region where you live:

Africa

Asia Western Pacific

Europe

North America Caribbean

South America

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* 9. Enter your area of expertise:

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* 10. Are you actively involved with a World Physiotherapy specialty group?

I am not actively involved with a World Physiotherapy specialty group

International Acupuncture Association of Physiotherapy (IAAPT)

International Organisation of Aquatic Physiotherapists (IOAPT)

International Confederation of Cardiorespiratory Physiotherapists (ICCrPT)

International Society for Electrophysical Agents in Physiotherapy (ISEAP)

International Physical Therapists for HIV/AIDS, Oncology, Hospice and Palliative Care (IPT-HOPE)

International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT)

International Organisation of Physiotherapy in Mental Health (IOPTMH)

International Neurological Physical Therapy Association (INPA)

International Federation of Physiotherapists working in Occupational Health and Ergonomics (IFPOHE)

International Association of Physiotherapists working with Older People (IPTOP)

International Organisation of Physiotherapists in Paediatrics (IOPTP)

International Organization of Physiotherapists in Pelvic and Women's Health (IOPPWH)

International Private Physiotherapy Association (IPPTA)

International Federation of Sports Physical Therapy (IFSPT)

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* 11. Highest level of education

Bachelor

Master

Doctorate

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* 12. Position at your workplace

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* 13. Name of your workplace institution

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* 14. Language proficiency. Please indicate the languages in which you are fully professionally proficient

Arabic

Chinese

English

French

Spanish

Other (please specify)

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* 15. LinkedIn:

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* 16. ORCID number:

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* 17. Have you ever been a CPD provider (employed to provide CPD)?

Yes

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* 18. Have you ever taken part in CPD as an instructor/lecturer/speaker/facilitator?

Yes

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* 19. Describe your interest in volunteering as a peer reviewer for the World Physiotherapy CPD event recognition service (max. 250 words)

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* 20. Please upload your CV

PDF, DOC, DOCX, PNG, JPG, JPEG file types only.