2025 Award Nomination Submissions

NOMINATIONS ARE NOW OPEN
These nominations should be completed by Monday, June 2nd, 2025.

This year at the Fall Conference, APTA Oregon will take the opportunity to recognize those in our profession that have provided outstanding services to the profession of physical therapy. APTA Oregon has three awards that honor people that have gone the extra mile, the Mercedes Weiss Service Award, the Ricci Susick Advocacy Award, and the Distinguished Service Award. We also recognize PTs or PTAs living in Oregon who have made a positive impact in their community, workplace, or within APTA Oregon with the Regional Excellence Awards.

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Contact Information

First Name *

Last Name *

Organization *

Email *

Phone *

Candidate Information

Select the award form you would like to complete. *

Mercedes Weiss Service Award

Distinguished Service Award

Ricci Sussick Advocacy Award

Regional Oregon Award

Candidate First & Last Name *

Candidate Phone Number *

Candidate Email Address *

Please provide a support statement below, or attach a document.

Please provide a support statement below, or attach a document, which details this individual's contribution(s) to the physical therapy profession and/or association which you feel merit(s) recognition through the award for which you have nominated this candidate using the guidelines specified. Please be sure to provide information which meets the specific criteria for the award and include details about educational background, employment, APTA/APTA Oregon activities and other activities.

Please upload Candidate statement if you did not provide it above.

20MB max

Please verify that you have checked the “I'm not a robot” checkbox.