Site Visitor Application Instructions and Form

Instructions: Individuals interested in applying to serve as a Site Visitor for CARTE must complete the following for consideration:

  • Attach a current resume/vita
  • Provide a brief summary of interest in serving as a Site Visitor
  • To include the follow:
  • Interest in becoming a CARTE Site Visitor
  • Information regarding experience with external accreditation/regulatory agencies such as the Joint Commission, Commission on Accreditation of Rehab Facilities, Veteran’s Affairs or other health/human service organizations
  • Provide a summary of qualifications including the following
  • Credentials CTRS & state license numbers
  • Employment must be either a Recreational Therapy practitioner or educator or both
  • Level of education
  • Number of years of full time employment in the field of Recreational Therapy Number of years supervising interns
  • Number of years professional active involvement in state/regional/national organization/s
  • Site of Employment
  • Applicant must sign CARTE statement of confidentiality

Please provide the above information on the following forms and attaché a current resume/vita to these forms when you submit. You may send your application forms electronically to be consider as a CARTE Site Visitor to:

Site Visitor Application

Name:
Credentials:
Employer:
Working Title:
Mailing Address:
City/State/Zip
Phone: / Fax: / Email:
Describe current position: / my current position is primarily as a full-time recreational therapy educator
my current position is primarily as a full-time recreational therapy practitioner

Interest in Becoming a CARTE Site Visitor:

Briefly describe your interest in becoming a site visitor (include information on involvement with agencies such as JCAHO, CARF, the VA, or other health/human service organizational accreditation activities):

Qualifications:

CTRS Credential: / certification number
State RT License: / State License Number
Undergraduate Degree: / degree / institution / date
Graduate Degree: / degree / institution / date
Doctoral Degree: / degree / institution / date
Years of full-time work in RT:
Years of experience supervising RT interns / years Describe:
RT Employment History: / Agency / Dates / Position Title
Agency / Dates / Position Title
Agency / Dates / Position Title

Current Employment Position

Agency / Date of employment
Briefly describe your job duties

Signature: ______Date: ______

CARTE Site Visitor Confidentiality Agreement

I, (type name here), agree to participate in the accrediting process of the Committee on Accreditation of Recreational Therapy Education (“CARTE”) a Committee on Accreditation ("CoA") of the Commission for the Accreditation of Allied Health Education Programs (“CAAHEP”), as a site visitor. In order to carry out my duties and responsibilities as a site visitor, I understand that, while a site visitor at a program ("Program"), I may come in contact with certain student/faculty/institution information that is confidential in nature, including information that can be used to identify those parties ("confidential information").

I hereby attest that I shall hold as strictly confidential all information related to accreditation or re-accreditation activities, or other matters to which I have access as a member, consultant, site visitor, or agent of the Committee on Accreditation of Recreational Therapy Education (CARTE).

I attest that I shall not disclose to any person, now nor at any time in the future, either directly or indirectly, any information, not otherwise public, regarding sponsoring institutions, key personnel, students, related information, or Committee activities to which I have access, except as necessary to fulfill my CARTE responsibilities, without the prior written consent of the Chair of the CARTE.

I agree to handle all sponsoring institution or program documents and information not otherwise public, in such a way that they will not be inadvertently revealed to any other person. Also, I shall not maintain in my files any permanent record that contains confidential information after I have completed my duties to the institution, the program, or the CARTE, and will dispose of all such records securely.

I acknowledge that any breach of confidentiality is a serious matter and may result in action which may include my removal from the CARTE or legal action against me or the CARTE.

Finally, I agree to immediately notify the Chair of CARTE and the Program of any use or disclosure of confidential not permitted by this Confidentiality Agreement of which I become aware.

The terms of this confidentiality statement are effective immediately and will apply to all work performed by me in carrying out my responsibilities for the CARTE.

Signed this day of 201.
______
Signature
______
Printed Name

Return by email to:

Return by mail to: CARTE, C/O Thomas K. Skalko, Ph.D., LRT/CTRS, 1463 Saddlewood Dr., Greenville, NC 27858