**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**
1.
Do you possess 60 credits from an accredited college or university with at least 15 credits in health services, human services, education or the behavioral sciences? Please note, you must submit your transcript(s) with the application.
Yes
No
2.
Describe your experience assisting in the implementation of activity therapy programs under the supervision of a health care professional to include assisting in patient/client assessments for mentally ill patients, aged, or physically ill or physically disabled patients or developmentally disabled clients.
Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.
3.
Describe your experience administering and interpreting annual activity therapy assessments of patients.
This experience should be included on your application. If you do not possess this type of experience, please put N/A in the text box.
4.
Describe your experience formulating Individual Plans of Care, developing goals, and selecting specific treatment modalities in collaboration with other rehabilitation staff.
This experience should be included on your application. If you do not possess this type of experience, please put N/A in the text box.
Department of Budget and Management