Name: Facility/ Affiliation: Address: Phone: E-mail: (You will receive an e-mail confirmation)

ATTENDANCE FEES (CIRCLE APPROPRIATE AMOUNTS)

GOTA Members:

Prior to 9/11/15 After 9/11/15 OTR: $ 250.00 $ 275.00 COTA $ 225.00 $ 250.00 Student $ 50.00 $ 75.00 NON-GOTA Members: OTR: $ 350.00 $ 375.00 COTA: $ 325.00 $ 350.00 Student: $ 60.00 $ 85.00 Attending Friday night Student Only Event: (Only 75 seats available: Free)

YES_____ NO_____

Attending the GOTA Networking Reception Adult Guest(s) are $10 (Children not permitted)

YES_____ NO_____ GUEST COUNT______

Donation to GOTA-PAG Total enclosed:

Method of payment: Check (enclosed):___________________________

Visa/MasterCard Number:

Expiration date: CVV:

Breakout Session Preferences: (Necessary for room scheduling and handouts)

For Further details about each session please visit the GOTA website at www.gaota.com.

Special accommodations: I prefer vegan meals I need special accommodations as listed

below: ________________________________________

Georgia Occupational Therapy Association Annual Conference

September 18-20 Brenau University

999 Chestnut St. SE Gainesville, GA 30501

Featherbone

Communiversity www.brenau.edu

12 Contact Hours

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b c

6. a b

“OT: Catalyst for Change”

If your finding today’s healthcare environment challenging – this year’s

conference will be your catalyst for change! We are offering a variety of stimulating

topics, hands on labs and interactive sessions. Plan to join us for great offerings

in education, have time for socialization and networking, and have fun along the way.

FRIDAY, September 18th, 2015 4:00 pm-5:30 pm: Special Student only event:

Courage in Chaos: Amiee Copeland 6:00 pm-7:30 pm: Keynote Speaker:

Finding Meaning Though Struggle: Amiee Copeland

Dinner on your own (Enjoy Gainesville!) SATURDAY, September 19th, 2015 7:30 am-8:00 am: Registration 8:00 am-8:15 am: Opening Remarks

(Mary Shotwell, Ph.D., OT/L, FAOTA; Kim Stoops, MS, OTR/L, Conference Committee)

8:30 am-9:30 am: Keynote address: Practitioner Power: You ARE the One!

Barbara Schell, Ph.D, OT/L, FAOTA 9:30 am-9:45 am: Break 9:45 am-10:45 am: Concurrent Session 1(1 hr) a. Impact of iDevice app on learning

outcomes in an entry level OT kinesiology course: Jason Hughes, MS, OTR/L; Pamalyn Kearney, Ed.D. OTR/L, CAPS; Jodi Brown, OTS; Justin Williams, OTS

b. The Experiences and Activity Participation of Individuals with Parkinson’s Disease with Alternative Interventions: Wendy Holmes, Ph.D., OTR/L; Matthew Almand, OTS; Osei Akoto, OTS; Maria Balletti, OTS; Annie Le OTS; Ashley Hawkins, OTS

c. STEP-IN Mobility Protocol: Allison Gowens, MOT, OTR/L, Meredith Lu, PT, DPT

SATURDAY, September 19th 2015 (cont.) 11:00 am-12:00 pm: Concurrent Session 3 (1 hr) a. Current Capacity Building Needs of

Occupational Therapists Related to Older Driver Screening, Assessment and Intervention: Ranyoouri H. Senia, Ph.D., OTR/L, CLT, DRS

b. Taking of the Wraps: Self Management and Health Aging in the Older Adult: Kay Graham, MOT OTR/L

c. Improving Advocacy, Improving our Profession: Bethany Bearden, MS, OTR/L

12:00 pm-1:30 pm: GOTA Annual Business Meeting & Recognition Ceremony

Lunch Provided: Mary Shotwell, Ph.D., OT/L, FAOTA

1:30 pm-2:30 pm- Unopposed Exhibit Hour 2:30 pm-4:00 pm: Concurrent Session 3(1.5 hr) a. Electric Auditory Stimulation effect

application (EASe app for adolescents and adults with sensory processing deficits: A continuation study: Irma Alvarado, Ph.D, OT/L; Elizabeth Burch, MS, OTR/L; Ilse Espino, MS, OTR/L; Nicole Feldman, MS, OTR/L; Jessica Stockton, MS, OTR/L; David Cook, BS, MBA, MA; Jennifer Allison, MS, OTR/L

b. Mindfulness Based Interventions for Patients with Multiple Diagnoses and for Ourselves: Robin Underwood, Ph.D., OT/L

c. Therapy Dog: Is there a dog in the house? H. R. Nolin, CPP, CFR, Master K-9 Trainer; Angelina Marino, MHS, OTR/L

4:00 pm-5:30 pm Concurrent Session 3(1.5 hr) a. The Infinite Hand: Sheri Roberts, OTR/L,

CHT b. Making Every Moment Count in Georgia:

Debi Hinerfeld, MS, OTR/L c. Emotional Intelligence Experiential

Learning Workshop for Occupational Therapy Practitioners: Laura Carpenter, M.S.Ed, OTR/L; Megan Lentz, OTS; Jessica Randazzo, OTS; Jessica Waters, OTS

5:45 pm-7:30 pm: GOTA Networking Social: An Adventurous Soiree & Silent Auction

SUNDAY, September 20st, 2015 8:30 am-9:30 am: Legislative and Regulatory

Issues: Kay Bittick-Nelson, OTR/L; Tom Bauer, Legislative Consultant

9:30 am-11:00 am: (1.5 hr) a. CVA Treatment Strategies: Annette Russell-

Farmer, BS, OTR/L, C/NDT b. Three keys to overcoming resistance to

change: Peter Vajda, Ph.D., C.P.C 9:30 am-12:00 pm: Concurrent Session 3(2.5 hr) a. Using Essential Oils as a Sensory Strategy to

Effect Modulation, Mood and Behavior: Amanda Buono, MS, OTR/L; Jennifer Allison, MS, OTR/L; Amy Green, BSN/RN

b. Ethics Session: Andrea Birch Ph.D.; Mary Shotwell, Ph.D., OT/L, FAOTA

Housing Accommodations:

Hilton Garden Inn Gainesville 1735 Browns Bridge Road Gainesville, GA 30501. Rates: $105.00/night. Call: (770) 532-3396 Group code: GOTA

Whether you’re attending conference or not we want your opinion! Please take a moment

and follow the link below to fill out a short survey about membership. Thank you for

your support. https://www.surveymonkey.com/r/GOTAmem

bershipsurvey Please register either: (select only one method) • Online by accessing www.gaota.com (please

note some browsers might not work, if you experience difficulty please try a different browser)

• Submit paper registration & payment via fax to (770-433-2907)

• Submit paper registration & payment via mail to: GOTA 1260 Winchester Parkway, Suite 205 Smyrna, GA 30080

Questions: Email Ashley at info@gaota.com

Or Call Tiffany at 678-554-8258