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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 Date(s):

Location of Seminar: XX (b)(6)


Subject/Objective of Your Attendance (benefits to ARC, Inc.):

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 (b)(6) Profession: PT PTA xx CPO


LAST FIRST

Home Address XX
STREET CITY STATE ZIP

Employer/Office AMERICAN REHABILITATION CENTER, INC.

Home Phone ( ) Business Phone ( )

Check Date And Location You Will Be Attending: Make check payable
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 informa-


tion 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