Mailing Addresses Order Form

NOTICE: Consistent with APTA position opposing referring physician ownership of physical therapy practices, the OPTA does not knowingly supply mailing addresses to clinics and/or facilities which are owned or controlled by referral sources.
Mailing Addresses will be listed in an Excel document and sent by email.
Please check here to acknowledge understanding of our Physician Owned Practices stance.
CHOOSE YOUR DISTRICT (check all that apply)
  100.00 Northeast (Cleveland Area)
  100.00 Northwest (Toledo Area)
  100.00 East Central (Akron/Youngstown Area)
  100.00 Central (Columbus/Athens Area)
  100.00 West Central (Dayton Area)
  100.00 Southwest (Cincinnati Area)
Purpose for which mailing addresses are ordered:
First Name
Last Name
City State Zip
   - denotes required fields