APTA Home Health: 2026 Consent to Serve

APTA Home Health: 2026 Consent to Serve
Name

First NameLast Name
Credentials/Designations
APTA Member Number
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

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Postal / Zip Code
Consent

Please check one box for each position for which you consent to serve and be slated as a candidate for election. By consenting, you agree that your consent and name may be published as a candidate for an APTA Home Health Academy elected office.
Nominating Committee
Secretary
Duties of the above positions are described in the Home Health Academy Bylaws and the relevant job description. It is expected that elected Home Health Academy leaders will not be restricted by their employment responsibilities from attending, and be willing to attend, Academy Board and Business meetings when required by their leadership roles. By typing in your name below, you affirm that you meet the eligibility requirements of this office as stated in the Academy's Bylaws.

https://aptahhs.memberclicks.net/assets/Home%20Health%20Section%20Bylaws_February%202021.pdf
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Date

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