Internship Site Application

Practice Name: *

Street Address *

Address Line 2

City *

State/Province/Region *

Zip/Postal Code *

Country *

Office Phone Number *

Website *

CRI Internship Contact Name (For communications with the CRI team and Krista Niebaum, the Internship Coordinator) *

CRI Internship Contact Email Address (For communications with the CRI team and Krista Niebaum, the Internship Coordinator) *

1. Internship Contact Name (for students to set up an internship, can be the same person listed above) *

2. Internship Contact Email Address (for students to set up an internship, can be the same as listed above) *

3. List of Primary Clinical Mentors (Veterinarians and/or PT's certified in rehabilitation):
*Including yourself and include degrees and certifications* *

4. Proof of Certification: If a mentor is not a CRI graduate, please upload a copy of their rehabilitation certification

5. Date of certification in canine rehabilitation for each mentor: *

6. Number of years each mentor has practiced canine rehabilitation and please indicate if full-time or part-time: *

7. Please list the names, titles, degrees, and certifications of any other rehabilitation-certified staff not noted above, including veterinarians, PTs, veterinary technicians, and veterinary assistants: *

1. If you practice in other areas, what percentage of your practice is in animal rehabilitation? *

0100

2. In your rehabilitation therapy caseload, what is the typical % of various patient types? (Orthopedic, Neurological, Geriatric, Sporting Dogs, Prosthetics/Orthotics, Wheelchair Fitting, Other) *

3. What is the approximate number of rehabilitation patients seen per day and per calendar week in your practice? *

4. What rehabilitation equipment is available in your practice? And what services does your practice offer in addition to rehabilitation? *

5. Is observing surgery a possibility for interns? *

6. Please select the type of students you are willing to mentor: *

CCRVT/N and CCRA (Veterinary Technicians/Assistants)

CCRT (Veterinarians)

CCRT (Physical Therapists)

7. Please list your practice's rehabilitation therapy working days and hours: *

8. Recommended compensation for an internship is $100-$200 per day, paid directly by the student to you/your clinic; some practices have no fee.
Please indicate a specific amount to be listed as your daily fee for an intern: *

9. Is your rehabilitation caseload large enough to guarantee an intern 40 hours of rehabilitation experience in one week?

If not, are you open to hosting interns on a part-time basis over 2-3 weeks to complete the 40-hour requirement? *

10. Do you want to share anything about your practice with potential interns?
(Scheduled one-on-one mentoring time, staff dogs available for additional hands-on practice, specific treatments/modalities offered at the practice, time available to discuss rehabilitation practices business aspects, etc.) *

For Physical Therapist applications only:
My animal rehabilitation therapy practice complies with my state's/province's/territory's Veterinary and Physical Therapy Practice Acts such that, if required: The practice receives any necessary veterinary referrals before initiating therapy; The practice includes sufficient veterinary supervision. I do not perform therapies beyond my scope of practice (i.e., dry needling on veterinary patients). Additionally, the treatments provided by the Physical Therapist(s) on staff are within the approved scope of practice for a Physical Therapist in my state/province/territory.

Yes

For the practice's primary mentor:
As a CRI internship mentor (a veterinarian or physical therapist certified in canine rehabilitation), I will work closely with CRI students and provide them with hands-on experience in the rehabilitation process (not observation-only), in particular manual assessment and treatment techniques, land-based therapeutic exercise techniques, and developing the plan of care, including HEP.
I understand that most of the intern's time will be spent with me or another veterinarian or physical therapist certified in canine rehabilitation. *

Yes

Mentor/Primary Contact Signature *

clear

Thank you for your application! Please allow 1-2 weeks for review after which you will receive notification of acceptance status. If you have any questions about the status of your application, please contact Krista Niebaum, CRI Internship Coordinator, at krista@caninerehabinstitute.com

If you haven't already, and you are a graduate of CRI, please take a moment to add yourself to our Find A Therapist page!

This helps clients and colleagues find you!