Physical Therapy
Neonatology Fellowship Application
Instructions: Complete entire form (use as much space as necessary). Submit the completed
application by emailing this form as well as a current CV, to Fellowship Director – Jane K. Sweeney PT,
PhD, PCS, FAPTA – jsweeney@rmuohp.edu.
Applicant Name: Click here to enter text.
Address: Click here to enter text.
Phone: Click here to enter text.
Email: Click here to enter text.
Educational Background:
Undergraduate Institution: Click here to enter text.
Degree: Click here to enter text. Year Graduated: Click here to enter a date.
Graduate Institution: Click here to enter text.
Degree: Click here to enter text. Year Graduated: Click here to enter text.
Professional Reference Contact Info:
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Work Relationship: Click here to enter text.
2) Name: Click here to enter text. Phone: Click here to enter text. Email: Click here to enter text.
Work Relationship: Click here to enter text.
3) Name: Click here to enter text. Phone: Click here to enter text. Email: Click here to enter text.
Work Relationship: Click here to enter text.
Pediatric Experiences Including Neonatal Exposure:
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Statement of Goals and Expectations of Fellowship Training (including description of intent to
participate in neonatal care in the future):
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561 East 1860 South  Provo, Utah 84606  801.375.5125  866.780.4107 Toll Free  801.375.2125 FAX
jsweeney@rmuohp.edu  www.rmuohp.edu
Admission Requirements
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Minimum of 3 years’ experience (5 years preferred) in pediatric physical therapy with
clinical exposure to infants. At this time, board certification in pediatric physical therapy
by the American Board of Physical Therapy Specialties is not required. Instead, a
careful analysis of clinical experience and professional contributions is conducted.
Updated curriculum vitae
Physical Therapy licensure in Washington state
Liability insurance and health insurance
Detailed statement of goals and expectations of the fellowship training and description
of intent to participate in neonatal care in the future
References from 3 professionals
Admission to the Graduate School, Rocky Mountain University of Health Professions,
Provo, UT
Interview and site visit with the Neonatology Fellowship leadership team
o Fellowship Director
o Fellowship Site Manager, Seattle Children’s Hospital
o Director of Physical Therapy, Seattle Children’s Hospital
$100 Application Fee
Admission Decision
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Applicants are informed of the admission decision after the review of application,
reference checks, personal interview / site visit, and University admission approval.
Fellowship Duration: 12-18 months
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Academic phase: August/September start at Rocky Mountain University of Health
Professions in blended learning format (face-to-face on campus and directed
independent study at home)
Clinical Phase: January - July/August at Seattle Children’s Hospital
Option for clinical phase in 2 segments of approximately 3 months with fellowship
completion in maximum of 18 months
Financial Model
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Training Stipend: $5000
Optional part-time clinical work (pediatric caseload) with salary commensurate with
revenue-generating clinical time. Job description available on request.
561 East 1860 South  Provo, Utah 84606  801.375.5125  866.780.4107 Toll Free  801.375.2125 FAX
jsweeney@rmuohp.edu  www.rmuohp.edu