How To Register: Oncology Conference Contact Details Registration Fees

Transcription

How To Register: Oncology Conference Contact Details Registration Fees
Oncology Conference
How To Register:
April 12 - 13, 2013 - Travelodge Hotel - Saskatoon
Phone: (306) 966-7790/(306) 966-7795
Fax: (306) 966-7673 Email: cme@usask.ca
Contact
Details
Dr.
Mr.
Ms.
Mail: Continuing Professional Learning
College of Medicine, University of Saskatchewan
Box 60001 RPO University
Saskatoon, SK S7N 4J8
First Name
Last Name
Mailing Address
City
Area Code
Prov
Telephone
Area Code
Postal Code
Fax
-
-
E-mail Address (Required)
Registration Fees
U of S GST # 11927 9313 RT0001
Please note that we accept payment only by credit card or institutional cheque payable to Continuing Professional
Learning. Registration will not be processed until payment is received.
 Physicians:
Before and on March 28
$420.00 ($400.00 + 20.00 GST) March 28 and after
$472.50 ($450.00 + 22.50 GST)
 Nurses, Pharmacists and
other Health Professionals:
$304.50 ($290.00 + 14.50 GST) $357.00 ($340.00 + 17.00 GST

Residents & Students:
$131.25 ($125.00 + 6.25 GST)
(PROOF OF FULL-TIME STUDENT OR RESIDENT STATUS REQUIRED)
Family Physician
Specialist* _________________
Pharmacist
FLAT RATE
Other* ____________________
Resident *__________________
Student *___________________
Nurse/NP
Physiotherapist
Social Workers
*(Please Specify)
Payment Information
$ Total Amount Enclosed ___________________
Credit Card Payment:
VISA
Expiry MM/YY
MC

Institutional Cheque
Card Number
Signature
Cancellation & Refund Policy
*REQUIRED
Cancellations must be received in writing by April 4, 2013, and will be subject to a $75.00 administration fee.
Refunds will not be considered on or after April 5, 2013. The conference organizers reserve the right to cancel
or postpone this course due to insufficient registration or circumstances beyond our control. This course may be
cancelled up to twenty (20) days prior to the course date. In such case each registrant will be notified by telephone
or email with written notification and a full refund following. The conference organizers are not responsible for any
other costs including but not limited to airline or hotel penalties.
Oncology Conference
April 12 - 13, 2013 - Travelodge Hotel - Saskatoon
Print Name Here _____________________________________________________________
Please indicate any food allergies or restrictions:__________________________________
USE THIS FORM TO SELECT YOUR CONCURRENT SESSIONS. Please indicate your first and
second choices, using a 1 or 2, for each set of concurrent sessions.
Please Note: Program content and speakers are subject to change.
Friday, April 12, 2013
Concurrent Sessions - A - Case Discussions (Choose two)
_____
A-1 Prostate Cancer Update - Dr. Shari McKinny
_____
A-2 Treatment of Colorectal Cancer - Case Studies & Treatment Options - Dr. Janine Davies
A-3 When Pediatric Cancer Survivors Become Adults - Dr. Roona Sinha, Dr. Tanya Brown, & Rick Pryor
_____
_____
A-4 Thrombosis in the Cancer Patient - Dr. Otto Moodley
Concurrent Sessions – B - Case Discussions (Choose two) _____
B-1 Targeted Therapies for Cancer - Toxicity Profiles & Management - Kathy Gesy
_____
B-2 Breast Cancer Update - Dr. Michael Harington & Dr. Kamal-Uddin Haider
_____
B-3 Lung Cancer Update - Dr. Renee Kennedy & Dr. Amer Sami
_____
B-4 Oncologic Emergencies & Red Flags - Dr. Theresa Bradel & Dr. Joanne McLeod
Saturday, April 13, 2013
Concurrent Sessions – C - Case Discussions (Choose two)
_____
C-1 Gynecological Cancer Update - Dr. Maryam Al-Hayki & Dr. Shazia Mahmood
_____
C-2 Hematological Cancers Update - Dr. Rebecca MacKay
_____
C-3 Sexual Dysfunction - Dr. Trustin Domes & Dr. Christopher Giede
_____
C-4 Supporting Patients with a Long Cancer Journey - Bruce Schmidt

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