Rates and Order Form (.pdf)

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SAMPLE LISTINGS. BASIC LISTING ... company, its products and services. ENHANCED LISTING. $345.00. Includes 100 word marketing message, 4/color logo, and unlimited ... jpg format, contact information and your 100-word listing in a ...
ONLINE BUYER’S GUIDE RATES AND ORDER FORM BASIC LISTING $99.00 Includes one alphabetical and five product category listings.

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Company Name _______________________________________________________ Address_______________________________________________________________

BASIC PLUS LISTING $199.00 Includes one alphabetical and up to twenty product category listings.

City State Zip__________________________________________________________ Phone_______________________________Fax______________________________

Email________________________________________________________________

ENHANCED LISTING $345.00 Includes 100 word marketing message, 4/color logo, and unlimited product category listings.

Web site_______________________________________________________________

Please submit a high resolution logo (300 x 300) in jpg format (40kb and under), contact information and your 100-word listing in a separate Word document. E-mail the logo and listing to Jane Richardson at [email protected].

Contact _________________________________Contact title_____________________

ALL listings run in twelve month cycles. All online listings purchased by May 15, 2014 will automatically be listed in the Print Buyer’s Guide due to publish as the August 2014 issue of PT in Motion!

LISTINGS – Choose One ¨ Basic Listing (includes 5 category listings) ¨ Basic PLUS (includes up to 20 categories) ¨ Enhanced Listing (includes unlimited categories)

BANNER ADVERTISING Size Header Banner (468 x 60)

Monthly $750.00

Contract Start Date_______________________Contract End Date_________________

Contracts run in 12 month cycles

Annual $7,500.00

SAMPLE LISTINGS BASIC LISTING

ENHANCED LISTING

Total Listing Investment BANNER ADVERTISING Annual

$___________

¨

$7,500.00

Annual Header Banner

Monthly

Rate/Month

No. of Months

Banner Investment

¨ Header Banner

$750.00

___________

_____________

Company Name

Company Name

Total Banner Investment

4/COLOR LOGO

Address City, State, Zip Phone FAX Web Site

BANNER ADVERTISING SCHEDULE Please check the dates to schedule your banner advertising:

100-word maximum description of your company, its products and services. All banners & listings must be paid for in advance

¨ American Express

$____________

TOTAL INVESTMENT ______________ (Includes Listing & Banner Totals)

Category(s) Category(s) Address City, State, Zip Phone FAX Web Site

$ 99.00 $199.00 $345.00

Month

Year

Month

Year

Month

Year

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September October November December

January February March April

CREDIT CARD INFORMATION

¨ Master Card

¨ Visa

Card Number____________________________________________Expiration Date_________ Name on Card________________________________________________________________ Card Billing Address____________________________________________________________ City/State/Zip___________________________________________________________ I authorize the above credit card to be charged for $________ for advertising on APTA’s Online Buyer’s Guide

Authorized Signature

Title/Position

Date

PLEASE RETURN THIS FORM TO JANE RICHARDSON AT [email protected]

May June July August

COMPANY CONTACT NAME E-MAIL TELEPHONE NUMBER DATE Please indicate ALL categories that your company is to be listed. For a Basic Listing you can be listed under 5 categories, Basic Plus Listing – 20 categories, and Enhanced Listings – unlimited categories. ---------------------------------------------------------AMBULATION / MOBILITY ¨ 0101 Automotive ¨ 0102 Cane Accessories ¨ 0103 Canes, Quad ¨ 0104 Canes, Rigid ¨ 0105 Crutch Accessories ¨ 0106 Crutches ¨ 0107 Gait Training ¨ 0108 Parallel Bars ¨ 0109 Pediatric Mobility Devices ¨ 0110 Ramps ¨ 0111 Scooters ¨ 0112 Standing Aids ¨ 0113 Strollers ¨ 0114 Training Stairs ¨ 0115 Walker Accessories ¨ 0116 Walkers ¨ 0117 Walkers, Pediatric ¨ 0118 Walkers, Training ¨ 0119 Walkers, Wheeled ¨ 0120 Miscellaneous Ambulation/Mobility APTA ENDORSED MEMBER PROGRAMS ¨ 0151 AD&D and Professional Liability Insurance ¨ 0153 Auto Insurance Discount Program ¨ 0154 Business & Personal Credit Card Program ¨ 0164 Business Overhead Expense ¨ 0166 Car Rental Discounts ¨ 0157 Dental Insurance ¨ 0167 International Medical Travel Insurance ¨ 0163 Life, Health, Long-Term Care and Disability Insurance ¨ 0161 Student Health Insurance

ASSISTIVE DEVICES ¨ 0201 Augmentative Communication Devices ¨ 0202 Clothing ¨ 0203 Dressing Aids ¨ 0204 Drinking Aids ¨ 0205 Driving Aids ¨ 0206 Eating Aids ¨ 0207 Grab Bars, Bathroom ¨ 0208 Grooming Aids ¨ 0209 Toilet Seats ¨ 0210 Transfer Boards ¨ 0211 Writing Aids ¨ 0212 Miscellaneous Assistive Devices BEDS / ACCESSORIES ¨ 0301 Beds/Bed Accessories ¨ 0302 Gel Pads ¨ 0303 Mattresses ¨ 0304 Railings ¨ 0305 Restraints ¨ 0306 Trapeze Bars ¨ 0307 Miscellaneous Beds/ Accessories BUSINESS MANAGEMENT SERVICES ¨ 0414 Apps ¨ 0401 Billing Services ¨ 0402 Computer Hardware ¨ 0404 Consultants ¨ 0406 Dealers ¨ 0413 Documentation ¨ 0407 Financing ¨ 0408 Insurance ¨ 0409 Leasing ¨ 0410 Recruitment/Staffing ¨ 0412 Miscellaneous Business Management CHAIRS / WHEELCHAIRS ¨ 0501 Chairs, Arthritis ¨ 0502 Chairs, Elevated ¨ 0503 Chairs, Ergonomic ¨ 0504 Chairs, Lift ¨ 0505 Chairs, Tilt ¨ 0506 Wheelchairs ¨ 0507 Wheelchairs, Amputee ¨ 0508 Wheelchairs, Geriatric ¨ 0509 Wheelchairs, Pediatric ¨ 0510 Wheelchairs, Sports ¨ 0511 Wheelchair Seats / Supports ¨ 0512 Wheelchair Sports Accessories ¨ 0513 Wheelchair, Stand-Up ¨ 0514 Miscellaneous Chairs / Wheelchairs COLD THERAPY ¨ 0601 Cryotherapy ¨ 0602 Ice Packs, Disposable ¨ 0603 Ice Packs, Reusable ¨ 0604 Sprays, Vapocoolants ¨ 0605 Miscellaneous Cold Therapy

CUSHIONS / PADS / PILLOWS / PROTECTORS ¨ 0701 Air Pads ¨ 0702 Alternating Pressure Pads ¨ 0703 Ankle Protectors ¨ 0704 Back Rests/Cushions ¨ 0705 Elbow Protectors ¨ 0706 Felt/Foam Pads ¨ 0707 Foot Pads ¨ 0708 Heel Protectors ¨ 0709 Pillow Covers ¨ 0710 Pillows, Cervical ¨ 0711 Pillows, Flexion ¨ 0712 Pillows, Prone ¨ 0713 Pillows, Wedge ¨ 0714 Positioning Pads ¨ 0715 Water Pads ¨ 0716 Miscellaneous Cushions/ Pads/Pillows/Protectors EDUCATION ¨ 0801 Anatomy Models ¨ 0802 Continuing Education ¨ 0803 Education Financing ¨ 0804 Patient Instruction ¨ 0805 Publications ¨ 0806 Video Training ¨ 0807 Miscellaneous Education ELECTROTHERAPY MODALITIES ¨ 0901 Electrodes ¨ 0902 Electrotherapy Equipment ¨ 0903 Galvanic Stimulators ¨ 0904 Gels/Sprays ¨ 0905 Interferential Therapy ¨ 0906 Iontophoretic Systems ¨ 0907 Muscle Stimulators ¨ 0908 Neuromuscular Stimulators ¨ 0909 TENS Units ¨ 0910 Miscellaneous Electrotherapeutic EXAMINATION / TESTING ¨ 1001 Back Testing and Rehabilitation ¨ 1002 Body Composition Analyzers ¨ 1003 Computerized Functional Analyzers ¨ 1004 Dynamometers ¨ 1005 Electromyography ¨ 1006 Functional Capacity Testing ¨ 1007 Gait Analysis ¨ 1008 Goniometers/ Inclinometers ¨ 1009 Isokinetic Exercise, Testing, Rehabilitation, and Screening ¨ 1010 Isolated Joint Exercise ¨ 1011 Lift Task Stations ¨ 1012 Motion Analysis ¨ 1013 Multi-Joint Testing ¨ 1014 Musculoskeletal Testing and Rehabilitation ¨ 1015 Orthopedic Diagnostics ¨ 1016 Performance/Motion Quantification and Analysis ¨ 1017 Pulse Readers ¨ 1018 Miscellaneous Examination/ Testing

PLEASE RETURN THIS FORM TO JANE RICHARDSON AT [email protected]

Company Name __________________ GENERAL EQUIPMENT & SUPPLIES ¨ 1101 Bandages, Elastic ¨ 1102 Boards, First Aid ¨ 1103 Cabinetry ¨ 1104 Deodorizers ¨ 1105 Ergonomically Designed Products ¨ 1106 Incontinence ¨ 1107 Intermittent Compression Systems ¨ 1108 Maintenance and Repair ¨ 1109 Massagers ¨ 1110 Obesity, Special Equipment ¨ 1111 Obstetric Equipment/Supplies ¨ 1112 Scales ¨ 1113 Stretchers ¨ 1114 Tables, Adjustable ¨ 1115 Tables, Massage/Treatment ¨ 1116 Tape ¨ 1117 Miscellaneous General Equipment and Supplies HEAT THERAPY ¨ 1201 Diathermy, Microwave ¨ 1202 Diathermy, Shortwave ¨ 1203 Fluidotherapy ¨ 1204 Heating Pads ¨ 1205 Hot Packs ¨ 1206 Moist Heat Pads ¨ 1207 Paraffin Baths ¨ 1208 Miscellaneous Heat Therapy HYDROTHERAPY ¨ 1301 Bath Seating Systems ¨ 1302 Bathtubs ¨ 1303 Deep Water Therapy Tanks ¨ 1304 Flotation Devices ¨ 1305 Foot Baths ¨ 1306 Hydrotherapy Equipment ¨ 1307 Sitz Baths ¨ 1308 Therapeutic Pools ¨ 1309 Tub Benches/Seats ¨ 1310 Water Sanitizing Systems ¨ 1311 Whirlpool Additives ¨ 1312 Whirlpools ¨ 1313 Miscellaneous Hydrotherapy LIFTS / TRANSFER DEVICES ¨ 1401 Lifts, Bathroom ¨ 1402 Lifts, Driving ¨ 1403 Lifts, Platform ¨ 1404 Lifts, Pool ¨ 1405 Lifts, Track ¨ 1406 Lifts, Transfer ¨ 1407 Patient Transfer Slings ¨ 1408 Miscellaneous Lifts/Transfer Devices ORTHOSES / SHOES / SPLINTS / SUPPORTS – GENERAL ¨ 1501 Athletic Supports ¨ 1502 Immobilizing Pads/Devices ¨ 1503 Orthopedic Appliances ¨ 1504 Restraints, Wheelchair ¨ 1505 Splinting Materials ¨ 1506 Splints, Disposable ¨ 1507 Splints, Inflatable ¨ 1508 Miscellaneous General

ORTHOSES / SHOES / SPLINTS / SUPPORTS – LOWER EXTREMITY ¨ 1601 Braces, Ankle ¨ 1602 Braces, Knee ¨ 1603 Braces, Leg ¨ 1604 Hosiery, Compression ¨ 1605 Hosiery, Support/Elastic ¨ 1606 Shoes, Custom/Moldable ¨ 1607 Shoes, Post-Op ¨ 1608 Splints/Orthoses, Foot ¨ 1609 Splints/Orthoses, Leg ¨ 1610 Supports, Ankle ¨ 1611 Supports, Arch ¨ 1612 Supports, Knee ¨ 1613 Miscellaneous Lower Extremity ORTHOSES / SHOES / SPLINTS / SUPPORTS – NECK & TRUNK ¨ 1701 Braces, Back ¨ 1702 Braces, Spinal ¨ 1703 Cervical Collars ¨ 1704 Lumbar Rolls ¨ 1705 Rib Belts ¨ 1706 Supports, Abdominal ¨ 1707 Supports, Back ¨ 1708 Supports, Maternity ¨ 1709 Supports, Sacral ¨ 1710 Miscellaneous Neck and Trunk ORTHOSES / SHOES / SPLINTS / SUPPORTS – UPPER EXTREMITY ¨ 1801 Braces, Arm ¨ 1802 Braces, Hand ¨ 1803 Compression Sleeves ¨ 1804 Slings, Arm ¨ 1805 Splints/Orthoses, Arm ¨ 1806 Splints/Orthoses, Finger ¨ 1807 Splints/Orthoses, Hand/ Wrist ¨ 1808 Supports, Elbow ¨ 1809 Supports, Hand ¨ 1810 Supports, Wrist ¨ 1811 Miscellaneous Upper Extremity OUTCOMES / DATA COLLECTION ¨ 1901 Outcomes/Data Collection PROSTHESES ¨ 2001 Prostheses ¨ 2002 Prosthetic Socks ¨ 2003 Miscellaneous Prostheses THERAPEUTIC EXERCISE / INTERVENTION ¨ 2101 Aquatic Exercisers/ Equipment ¨ 2102 Balance Beams/Boards ¨ 2103 Bicycles, Adapted ¨ 2104 Bicycles, Ergometric ¨ 2105 Bicycles, Exercise ¨ 2106 Biofeedback Instrumentation ¨ 2107 Cardiac Rehabilitation ¨ 2108 Computerized Functional Training ¨ 2109 Continuous Passive Motion

THERAPEUTIC EXERCISE / INTERVENTION (CONTINUED) ¨ 2110 Exercise Equipment ¨ 2111 Exercise Software ¨ 2112 Exercisers, All-Body ¨ 2113 Exercisers, Arm ¨ 2114 Exercisers, Finger ¨ 2115 Exercisers, Hand ¨ 2116 Exercisers, Jaw ¨ 2117 Exercisers, Leg ¨ 2118 Isokinetic Equipment ¨ 2119 Isotonic Equipment ¨ 2120 Mats, Exercise ¨ 2121 Mobility Machines ¨ 2122 Pediatric Rehabilitation Equipment ¨ 2123 Portable Gyms ¨ 2124 Postural Drainage Devices ¨ 2125 Pulmonary Rehabilitation ¨ 2126 Putty, Therapeutic ¨ 2127 Rowing Machines ¨ 2128 Treadmills ¨ 2129 Variable Resistance Fitness Systems ® ¨ 2130 VELCRO Accessories ¨ 2131 Vestibular Stimulation ¨ 2132 Weights, Pediatric ¨ 2133 Weights, Pulley ¨ 2134 Weights, Wrist/Hand/Ankle ¨ 2135 Wheelchair Exercise Systems ¨ 2136 Miscellaneous Therapeutic Exercise/Intervention TRACTION ¨ 2201 Ankle ¨ 2202 Cervical ¨ 2203 Leg ¨ 2204 Lumbar ¨ 2205 Pelvic ¨ 2206 Traction Equipment ¨ 2207 Miscellaneous Traction ULTRASOUND ¨ 2301 Gels ¨ 2302 Ultrasound Equipment ¨ 2303 Miscellaneous Ultrasound WORK INJURY MANAGEMENT ¨ 2401 Ergonomic Equipment ¨ 2402 Work Conditioning ¨ 2403 Work Hardening ¨ 2404 Work Injury Prevention ¨ 2405 Miscellaneous Work Injury Management WOUND CARE / INTEGUMENTARY REPAIR & PROTECTION ¨ 2501 Creams ¨ 2502 Decubitus Ulcer Products ¨ 2503 Dressings ¨ 2504 Hyperbaric Oxygen Chambers ¨ 2505 Liniments ¨ 2506 Pressure Garments ¨ 2507 Miscellaneous Wound Care

PLEASE RETURN THIS FORM TO JANE RICHARDSON AT [email protected]