C.F.S.O.P. - Central Florida Society of Optometric Physicians

C.F.S.O.P. - Central Florida Society of Optometric Physicians

C.F.S.O.P.
Central Florida Society
of Optometric Physicians
PRSRT STD
U S POSTAGE
PAID
ORLANDO, FL
PERMIT NO 4190
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Hang Thai, OD
3119 Daniels Rd, Ste. 110
Winter Garden, FL 34787
efax: 407-654-5423
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Rosen Plaza Hotel H Orlando, Florida
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Excellent
Continuing
Education!
Sunday,
October 2, 2016
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EyeMed Course
Schedule
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Sunday, October 2, 2016
COPE Event ID Pending
7:00 – 8:00 am................................ Registration & Breakfast
8:00 – 9:40 am (2 Hrs. TQ) COPE: pending
“An Ocular Grand Rounds Tour of Orlando”
John Spalding, OD, FAAO
9:50 am – 11:30 am (2 Hrs. TQ) COPE: 41427-SD
“The Medical Management of Ocular Surface Disease”
Mark Dunbar, OD, FAAO
11:30 am – 1:00 pm.................................Lunch and Exhibits
1:00 – 2:40 pm (2 Hrs. TQ) COPE: 46289-PS
“The Greatest Posterior Segment Disease Course Ever”
Elias Mavrofrides, MD and Mark Dunbar, OD, FAAO
2:50 – 4:30 pm
“Prevention of Medical Errors”
Brian Den Beste, OD, FAAO
4:40 – 6:20 pm
“Florida Jurisprudence”
Alice Sterling, OD
Continuing Education Credit
•This program includes Florida Jurisprudence and Medical Errors,
required by the Florida Board of Optometry for licensure renewal.
•This educational program has been submitted to the State of Florida
- Board of Optometry for CE and Transcript Quality approval and
COPE.
•Registration fee includes continental breakfast, refreshment breaks
and luncheon.
•Half day fee not available.
EyeMed Cancellation Policy
• No refunds after September 23, 2016.
•Cancellations will only be accepted before September 23, 2016.
•Refunds are processed only after a written request is received by
Dr. Steve Zorn by email sjzornod@gmail.com.
•An administrative fee of $50.00 is retained on all refunds.
Sunday, October 2, 2016
Register On-line: www.cfsop.org
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Register online at:
www.cfsop.org
or
Complete and mail to:
Hang Thai, OD
3119 Daniels Rd, Ste. 110
Winter Garden, FL 34787
Phone: 407-654-5453
Include check payable to:
Central Florida Society of
Optometric Physicians
or
Fax your credit card
registration to:
Private Fax: 407-654-5423
For Information:
Dr. Hang Thai
407-654-5453
of
Please Print:
Central Florida Society
Optometric Physicians
REGISTRANT’S NAME:
MAILING ADDRESS:
CITY:
STATE:
PHONE (WORK):
ZIP:
PHONE (HOME):
EMERGENCY MOBILE NUMBER:
EMAIL ADDRESS:
REGISTRATION
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Meeting Registration Information
Rosen Plaza Hotel
9700 International Dr.
Orlando, Florida
AOA/FOA MEMBERSHIP #:
REGISTRATION FEES:
FLORIDA LICENSE NUMBER:
Received Before
September 19th
Received After
September 19th
AOA/FOA MEMBER........................... $300...................... $325......................= $______________
AOA NON-MEMBER............................ $450...................... $500......................= $______________
GRAND TOTAL $_______________
CREDIT CARD REGISTRATION
Card #:
Expiration:
/
Cardholders Exact Name - Please Print:
Credit Card Billing Address (including zip code) - Please Print:
STREET:
CITY - STATE - ZIP CODE:
Signature:
H H H H H H H H
Thanks To Our Sponsors
H H H H H H H H
FLORIDA RETINA
INSTITUTE
®
Central Florida Retina
& The Macular Degeneration Center
ORLANDO EYE
INSTITUTE
®
DIVISION OF
PLAZA
ROSEN
HOT E L
9700 International Drive • Orlando, Florida 32819
(407) 996-9700
Reservations: (800) 627-8258
Fax: (407) 354-5774
www.rosenplaza.com
Single Occupancy Room Rate: $115.00 per night plus tax.
Reservation Cut Off Date: September 18, 2016.
nGroup Reference: Central Florida Society of Optometric
Physicians (CFSOP) EyeMed.
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Hotel room cancellations must be received 72 hours prior
to arrival to avoid one night charge to credit card forfeiting
deposit.
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NOTE: Please be sure to go to the Rosen Plaza Hotel, not the Rosen Centre.
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Johnson +Johnson Vision Care, Inc.
of
Central Florida Society
Optometric Physicians
2016 BOARD OF DIRECTORS
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President.............................................. Hang Thai, OD
Vice-Pres./Educ. Chair....Maria Mandese, OD, FAAO
Secretary-Treasurer.............................Steve Zorn, OD
Chairman of the Board.......................Mark Coan, OD
Industry Relations............................ Regina Tran, OD
Membership Chair........................... Jeri Graham, OD
Hospitality Chair............ Brian DenBeste, OD, FAAO
Communications Chair..................... Betty Wang, OD
Legislative Liaison.........................Alice Sterling, OD
Advisors to the Board...... Bradley Giedd, OD, FAAO
Kirk Smith, OD
EyeMed Chair.......................Karen Perry, OD, FAAO
Mark E. Perry, OD
Trustee...............................................David Dada, OD