You are on page 1of 5

August 26, 1993 AMERICAN REHABILITATION CENTERS XX (b)(6

)

To Whom it May Concern: American Rehabilitation, Inc., is a certified rehabilitation agency, employing 25 professionals to include physical therapists, physical therapy assistants, occupational therapists, occupational therapy assistants and speech pathologists. We encourage all of our employees to attend educational seminars, for the betterment of self and company. One of our employees has requested to attend your seminar "Lower-Limb Prosthetics Update" in xx on xx (b)(6) This individual is deaf and will require an interpreter. When I talked with your organization last week, I was informed that you do not have a list of interpreters, nor do you provide this type of service. I have been informed by the Association for the Hearing Impaired that the ADA (American Disabilities Act) provisions must be made available by the provider of services/products, for the disabled. Therefore, we are requesting your organization to be prepared for this therapist's attendance by providing an interpreter. I would appreciate a response from your company regarding this provision so that I can proceed with scheduling educational programs for our employees. Yours truly, Dawn E. Meyer, RN Facility Coordinator 01-03026 ​ ARC, Inc. [American Rehabilitation] Travel/Seminar Request & Expense Report [FORM] Employee Name: XX Position: P.T.

Assistant Seminar Name: LOWER LIMB PROSTHETICS UPDATE Location of Seminar: XX (b)(6) Subject/Objective of Your Attendance (benefits to ARC, Inc.):

Date(s):

There are many new components are available for kids and adults with lower Limb amputations. Learning how to distinguish among the new energy storing/releasing prosthetic feet. It will be benefitted for geriatric at Swope Ridge Geratric Center. Estimated Expense of Request: Actual Expense Incurred: Registration: $215 Travel*: $179 round trip airfare Meals: 0 Lodging: 0 Other: Total: $394 Total: Advance Requested: Date Required: Desired Itinerary: Date Departure: Time of Departure: From: K.C. XX 5:10 PM To: XX (b)(6) From: XX XX 6:01 PM To: K.C. Employee Signature: XX (b)(6) Date: 8/27/93 Approved/Disapproved: Date: Supervisor's Signature: Comments: *Facility will arrange air travel as requested in itinerary. Please note, lesser of air coach or mileage will be reimbursed. Revised 1/93 01-03028

LOWER-LIMB PROSTHETICS UPDATE - REGISTRATION FORM Name XX LAST (b)(6) FIRST CITY Profession: PT PTA xx CPO

Home Address XX STREET

STATE

ZIP

Employer/Office AMERICAN REHABILITATION CENTER, INC. Home Phone ( ) Business Phone ( ) Make check payable

Check Date And Location You Will Be Attending: to XX XX (b)(6) 01-03027

LOCATIONS AND ACCOMMODATIONS XX Room Rates: $85.00 Single or Double Deadline: XX XX Room Rates: $130.00 Single or Double Deadline: XX XX Room Rates: $98.00 Single or Double Deadline: XX BLock of rooms has been reserved for each location above. Contact the hotel directly Advanced Educational Seminars, Inc. to receive the group rates listed. After the servatons and group rates will be confirmed on a space available basis. EDUCATIONAL CREDIT: REGISTRATION FEES: XX $215 postmarked on/before XX $245 postmarked after XX XX $215 postmarked on/before XX $245 postmarked after XX XX $215 postmarked on/before XX $245 postmarked after XX

The registration fee includes all course sessions breaks, continental breakfasts and a comprehensive course handbook. All requests for refunds must be submitted in writing and postmarked 2 weeks prior to the seminar date. Requests for refunds made 2 weeks before the seminar date will be subject to a $50 administrative fee. NO refunds will be made during the 2 weeks immediately prior to each seminar. A confirmation letter, map of the area and information regarding ground transportation will be sent upon receipt of your registration form and fee. XX FOR ADDITIONAL INFORMATION Please Contact: XX Seminars for therapists, sponsored by a therapist XX XX

01-03029