Ke yn o te S peaker s
Transcription
Ke yn o te S peaker s
Purchase your ad in the 2015 Yearbook today! Either complete this form and send to MAOPS with your convention registration, or navigate to the website and pay online. Send your prepared ad (.pdf format) or your ad wording and layout to Glenda Accardo at glenda.is@me.com by Feb. 28, 2015. Include electronic photos you would like to use in your ad. Convention Guide Ad Purchase Ad Size (please circle): Business card - $50 Half page - $200 Quarter page - $100 Full page - $400 Send your ad specifications or prepared ad to: Glenda Accardo at glenda.is.@me.com Payment Method Check payable to: AMAOPS Credit card Mastercard Purchaser Name/Name on Card Billing Address on Card Send your ad payment to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65101 Visa Discover Card Number Expiration Date CVC # (3 digits on back) $1,000 VISA Gift Card Raffle MAOPS and AMAOPS are combining efforts to raise funds for the Wetzel Foundation Scholarship Program and DO Care Program! Buy one or more $50 raffle tickets for your chance to win a $1,000 VISA gift card. Drawing will take place at the Joint Luncheon on Sat. May 2, 2015. $50 Raffle Tickets Join Us MOAC Yearbook The Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons is excited to bring you the 2015 Yearbook! This full color online book is the perfect place to congratulate new MAOPS or AMAOPS officers, to recognize your mentors from medical school or during residency and to remember great times celebrated with the osteopathic family. Continuing Medical Education The Continuing Medical Education program features a Family Medicine track and an Internal Medicine track. The Chateau on the Lake April 29 - May 3, 2015 in Branson, Missouri Do not need to be present to win...but we would love to have you there! AMAOPS Schedule of Events Dr. Fillingane is a family physician practicing in Mississippi. Early in his career, three of Dr. Fillingane’s patients died from heart attacks over a period of 10 days. It was then that Dr. Fillingane vowed to do whatever he could to reduce cardiovascular risk in his patients. Saturday, May 2 Noon - 2:30 p.m. 6:00 - 9:00 p.m. AMAOPS Registration Full Name Address MAOPS/AMAOPS Joint Luncheon MAOPS President’s Reception & Banquet City State Invitation to Join AMAOPS AMAOPS is the Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons. Our objective is to unite all interested persons of osteopathic physicians for the purpose of creating a better understanding of osteopathic medicine among lay people. Thus, aiding in the improvement of public health. Zip Phone Email Join us for our Annual Membership Meeting! We would like to get to know you and work together in the future for osteopathic medicine! I am interested in becoming a member of the Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons (AMAOPS). Please contact me. I will be attending the AMAOPS Annual Membership Meeting on Friday, May 1, 2015. 2015 Physician Brochure for Emailing.indd 1 Mail your form to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65109 Keynote Speakers Beating Cardiovascular Disease AMAOPS Membership Meeting AMAOPS Past Presidents’ Luncheon Family Fun Night on Branson Belle Thursday, April 30: 7:00 a.m. - 4:30 p.m. Saturday, May 2: 7:00 a.m. - 4:45 p.m. FM & IM: Cardiovascular Disease Beating Cardiovascular Disease Sam Fillingane, DO FM & IM: Diabetes Classifying and Treating Diabetes Sam Fillingane, DO FM & IM: Congestive Heart Failure Management Decompensated CHF - The Emergent Patient Decompensated CHF - The Hospitalized Patient CHF - The Patient Being Discharged John Grider, DO Update in CHF Device Therapy Jessica Birchem, DO, FACC Cor Pulmonale & Pulmonary Hypertension Bill Galli, DO Post-Discharge and Chronic Outpatient CHF Management: Decreasing Admissions & Readmissions Christopher Veremakis, MD Friday, May 1: 7:00 a.m. - 5:15 p.m. AMAOPS Registration & Schedule Friday, May 1 9:30 a.m. - Noon 12:30 - 1:30 p.m. 7:00 - 10:30 p.m. Schedule of Events 117th Missouri Osteopathic Annual Convention Dr. Fillingane began his research and ultimately found that cardiovascular disease is a disease of inflammation that is caused by eight major disease state categories. By using a carefully guided history and physical, along with advanced cardiovascular lab and office testing and by treating each of the eight disease states from an inflammatory perspective, Dr. Fillingane has achieved amazing results. Recently, an outside organization data mined Dr. Fillingane’s patient cases over an eight-year period. While Dr. Fillingane practices in a state with one of the highest per capita cardiovascular event rates in the country, and while Dr. Fillingane’s patient population is made up entirely of high-risk patients with cardiovascular disease, the organization reported that Dr. Fillingane had a total of 1.2 heart attack patients per year, and there were no stroke occurrences over the last five years of the eight-year period studied. Sam Fillingane, DO Dr. Fillingane’s techniques of care are innovating progress being made in prevention of heart attacks and strokes. Come and learn Dr. Fillingane’s techniques so you, too, can beat cardiovascular disease in your patients. Bringing the Joy Back to the Practice of Medicine Joint Luncheon Guest Speaker Dr. Anderson’s new concept for providing better care meets the “perfect storm” of challenges confronting family practices today - an aging population, millions of newly insured coming into the system, new regulations, higher costs and lower reimbursements. Dr. Anderson’s message will help you once again feel the joy of practicing medicine. Join us to hear Dr. Anderson at the Joint Luncheon. FM: Ortho Pearls Fractures - What Can You Take Care Sam Fillingane, DO of in the Office? BEATING CARDIOVASCULAR Thomas Berkbigler, DO DISEASE MAOPS/AMAOPS Joint Luncheon Splint Lab MAOPS/AMAOPS JOINT FM & IM: Bringing the Joy Back to the John Bailey, DO, CLASSIFYING & TREATING LUNCHEON SPEAKER Practice of Medicine Thomas Berkbigler, DO, DIABETES Peter Anderson, MD Charles Orth, DO, Justin Puckett, DO Upper Extremity Pain and Management FM: Preventive Medicine Charles Orth, DO Wellness Exams Injection Lab Justin Puckett, DO John Bailey, DO, Thomas Berkbigler, DO, Genetic Counseling Charles Orth, DO, Justin Puckett, DO Bronson Riley, MS FM: Neuro Topics Adult Immunizations Headache Management Peter Anderson, MD Lana Hudanick, RN, BSN Roger Cady, MD IM: In-Patient Situations Tremors BRINGING THE JOY BACK TO Establishing Patient Competency Vikas Kumar, MD, PhD THE PRACTICE OF MEDICINE Ozark Center The Dementias Against Medical Advice Ozark Center Timothy Reuschel, JD Obstructive Sleep Apnea Juan Mella, MD Pharmacologic Induced Neurologic Disorders Constanza Martinez, MD IM: Miscellaneous Sunday, May 3: 7:00 a.m. - 11:00 a.m. Hypothermia & Hypothermia Cases IM: Focused on In-Patient Specialties FM: Technology in the Office David Tannehill, DO Infectious Disease - Antibiotic Social Media & Apps that Matter EKG Refresher & Arrhythmia Management Stewardship Michael Brown, DO Walter Coats, DO Bridget Bransteitter, DO Meaningful Use IM: Blood, Blood Clots & Bloody Messes Pulmonary Grab Bag Larry Henderson, BBA, CHPS Blood Transfusions Bill Galli, DO Primaris David Tannehill, DO Mixed Acid Base Cases Patient Portals Hypercoaguability & Acute Venous Thromboembolism Steven Thiel, MD Michael Brown, DO Chris Heuser, DO Managing In-Patient Psych Patient Hematology in the Trauma Patient & Delirium Kevin Hubbard, DO, FACOI Todd Hill, DO Surviving Sepsis Campaign Guideline Update & the Impact of the ProCESS Trial David Tannehill, DO Tentative schedule: Topics and presenters subject to change And More! AOA Update Code Status and End of Life Discussion E-Prescribing Pros & Cons of Various EHRs Primary care physicians across the country are struggling with lower revenue, longer hours and the feeling that they are unable to provide the kind of care they have in the past. Dr. Anderson knows this because he felt it - he lived it. In 2003, he developed a better way to manage his office and in doing so, he saved his practice and brought the joy back to the practice of medicine. KEYNOTE SPEAKER Please Note: Nurses, advanced-practice nurses, physician assistants and other allied healthcare professionals are welcome to attend the Missouri Osteopathic Annual Convention. Please share this brochure with the collaborating providers in your office. MAOPS has requested that the AOA Council on Continuing Medical Education approve this program for 43.5 AOA Category 1-A CME credits. Approval is currently pending for 26 AAFP Prescribed Credits with the AAFP Commission on Continuing Professional Development (COCPD). Peter Anderson, MD MAOPS has requested that the American College of Osteopathic Internists approve this program for 25 Category 1-A Internal Medicine specialist credits. 11/12/2014 10:01:17 AM Purchase your ad in the 2015 Yearbook today! Either complete this form and send to MAOPS with your convention registration, or navigate to the website and pay online. Send your prepared ad (.pdf format) or your ad wording and layout to Glenda Accardo at glenda.is@me.com by Feb. 28, 2015. Include electronic photos you would like to use in your ad. Convention Guide Ad Purchase Ad Size (please circle): Business card - $50 Half page - $200 Quarter page - $100 Full page - $400 Send your ad specifications or prepared ad to: Glenda Accardo at glenda.is.@me.com Payment Method Check payable to: AMAOPS Credit card Mastercard Purchaser Name/Name on Card Billing Address on Card Send your ad payment to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65101 Visa Discover Card Number Expiration Date CVC # (3 digits on back) $1,000 VISA Gift Card Raffle MAOPS and AMAOPS are combining efforts to raise funds for the Wetzel Foundation Scholarship Program and DO Care Program! Buy one or more $50 raffle tickets for your chance to win a $1,000 VISA gift card. Drawing will take place at the Joint Luncheon on Sat. May 2, 2015. $50 Raffle Tickets Join Us MOAC Yearbook The Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons is excited to bring you the 2015 Yearbook! This full color online book is the perfect place to congratulate new MAOPS or AMAOPS officers, to recognize your mentors from medical school or during residency and to remember great times celebrated with the osteopathic family. Continuing Medical Education The Continuing Medical Education program features a Family Medicine track and an Internal Medicine track. The Chateau on the Lake April 29 - May 3, 2015 in Branson, Missouri Do not need to be present to win...but we would love to have you there! AMAOPS Schedule of Events Dr. Fillingane is a family physician practicing in Mississippi. Early in his career, three of Dr. Fillingane’s patients died from heart attacks over a period of 10 days. It was then that Dr. Fillingane vowed to do whatever he could to reduce cardiovascular risk in his patients. Saturday, May 2 Noon - 2:30 p.m. 6:00 - 9:00 p.m. AMAOPS Registration Full Name Address MAOPS/AMAOPS Joint Luncheon MAOPS President’s Reception & Banquet City State Invitation to Join AMAOPS AMAOPS is the Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons. Our objective is to unite all interested persons of osteopathic physicians for the purpose of creating a better understanding of osteopathic medicine among lay people. Thus, aiding in the improvement of public health. Zip Phone Email Join us for our Annual Membership Meeting! We would like to get to know you and work together in the future for osteopathic medicine! I am interested in becoming a member of the Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons (AMAOPS). Please contact me. I will be attending the AMAOPS Annual Membership Meeting on Friday, May 1, 2015. 2015 Physician Brochure for Emailing.indd 1 Mail your form to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65109 Keynote Speakers Beating Cardiovascular Disease AMAOPS Membership Meeting AMAOPS Past Presidents’ Luncheon Family Fun Night on Branson Belle Thursday, April 30: 7:00 a.m. - 4:30 p.m. Saturday, May 2: 7:00 a.m. - 4:45 p.m. FM & IM: Cardiovascular Disease Beating Cardiovascular Disease Sam Fillingane, DO FM & IM: Diabetes Classifying and Treating Diabetes Sam Fillingane, DO FM & IM: Congestive Heart Failure Management Decompensated CHF - The Emergent Patient Decompensated CHF - The Hospitalized Patient CHF - The Patient Being Discharged John Grider, DO Update in CHF Device Therapy Jessica Birchem, DO, FACC Cor Pulmonale & Pulmonary Hypertension Bill Galli, DO Post-Discharge and Chronic Outpatient CHF Management: Decreasing Admissions & Readmissions Christopher Veremakis, MD Friday, May 1: 7:00 a.m. - 5:15 p.m. AMAOPS Registration & Schedule Friday, May 1 9:30 a.m. - Noon 12:30 - 1:30 p.m. 7:00 - 10:30 p.m. Schedule of Events 117th Missouri Osteopathic Annual Convention Dr. Fillingane began his research and ultimately found that cardiovascular disease is a disease of inflammation that is caused by eight major disease state categories. By using a carefully guided history and physical, along with advanced cardiovascular lab and office testing and by treating each of the eight disease states from an inflammatory perspective, Dr. Fillingane has achieved amazing results. Recently, an outside organization data mined Dr. Fillingane’s patient cases over an eight-year period. While Dr. Fillingane practices in a state with one of the highest per capita cardiovascular event rates in the country, and while Dr. Fillingane’s patient population is made up entirely of high-risk patients with cardiovascular disease, the organization reported that Dr. Fillingane had a total of 1.2 heart attack patients per year, and there were no stroke occurrences over the last five years of the eight-year period studied. Sam Fillingane, DO Dr. Fillingane’s techniques of care are innovating progress being made in prevention of heart attacks and strokes. Come and learn Dr. Fillingane’s techniques so you, too, can beat cardiovascular disease in your patients. Bringing the Joy Back to the Practice of Medicine Joint Luncheon Guest Speaker Dr. Anderson’s new concept for providing better care meets the “perfect storm” of challenges confronting family practices today - an aging population, millions of newly insured coming into the system, new regulations, higher costs and lower reimbursements. Dr. Anderson’s message will help you once again feel the joy of practicing medicine. Join us to hear Dr. Anderson at the Joint Luncheon. FM: Ortho Pearls Fractures - What Can You Take Care Sam Fillingane, DO of in the Office? BEATING CARDIOVASCULAR Thomas Berkbigler, DO DISEASE MAOPS/AMAOPS Joint Luncheon Splint Lab MAOPS/AMAOPS JOINT FM & IM: Bringing the Joy Back to the John Bailey, DO, CLASSIFYING & TREATING LUNCHEON SPEAKER Practice of Medicine Thomas Berkbigler, DO, DIABETES Peter Anderson, MD Charles Orth, DO, Justin Puckett, DO Upper Extremity Pain and Management FM: Preventive Medicine Charles Orth, DO Wellness Exams Injection Lab Justin Puckett, DO John Bailey, DO, Thomas Berkbigler, DO, Genetic Counseling Charles Orth, DO, Justin Puckett, DO Bronson Riley, MS FM: Neuro Topics Adult Immunizations Headache Management Peter Anderson, MD Lana Hudanick, RN, BSN Roger Cady, MD IM: In-Patient Situations Tremors BRINGING THE JOY BACK TO Establishing Patient Competency Vikas Kumar, MD, PhD THE PRACTICE OF MEDICINE Ozark Center The Dementias Against Medical Advice Ozark Center Timothy Reuschel, JD Obstructive Sleep Apnea Juan Mella, MD Pharmacologic Induced Neurologic Disorders Constanza Martinez, MD IM: Miscellaneous Sunday, May 3: 7:00 a.m. - 11:00 a.m. Hypothermia & Hypothermia Cases IM: Focused on In-Patient Specialties FM: Technology in the Office David Tannehill, DO Infectious Disease - Antibiotic Social Media & Apps that Matter EKG Refresher & Arrhythmia Management Stewardship Michael Brown, DO Walter Coats, DO Bridget Bransteitter, DO Meaningful Use IM: Blood, Blood Clots & Bloody Messes Pulmonary Grab Bag Larry Henderson, BBA, CHPS Blood Transfusions Bill Galli, DO Primaris David Tannehill, DO Mixed Acid Base Cases Patient Portals Hypercoaguability & Acute Venous Thromboembolism Steven Thiel, MD Michael Brown, DO Chris Heuser, DO Managing In-Patient Psych Patient Hematology in the Trauma Patient & Delirium Kevin Hubbard, DO, FACOI Todd Hill, DO Surviving Sepsis Campaign Guideline Update & the Impact of the ProCESS Trial David Tannehill, DO Tentative schedule: Topics and presenters subject to change And More! AOA Update Code Status and End of Life Discussion E-Prescribing Pros & Cons of Various EHRs Primary care physicians across the country are struggling with lower revenue, longer hours and the feeling that they are unable to provide the kind of care they have in the past. Dr. Anderson knows this because he felt it - he lived it. In 2003, he developed a better way to manage his office and in doing so, he saved his practice and brought the joy back to the practice of medicine. KEYNOTE SPEAKER Please Note: Nurses, advanced-practice nurses, physician assistants and other allied healthcare professionals are welcome to attend the Missouri Osteopathic Annual Convention. Please share this brochure with the collaborating providers in your office. MAOPS has requested that the AOA Council on Continuing Medical Education approve this program for 43.5 AOA Category 1-A CME credits. Approval is currently pending for 26 AAFP Prescribed Credits with the AAFP Commission on Continuing Professional Development (COCPD). Peter Anderson, MD MAOPS has requested that the American College of Osteopathic Internists approve this program for 25 Category 1-A Internal Medicine specialist credits. 11/12/2014 10:01:17 AM Friday, May 1 Thursday, April 30 12:20 - 1:20 p.m. ATSU-KCOM Alumni Luncheon KCUMB-COM Alumni Luncheon 4:30 - 7:30 p.m. Exhibit Hall Welcome Reception Meet our exhibitors while enjoying your favorite beverage and appetizers. We have “market shoppe” exhibitors mixed in with medical exhibitors. You may find a product you never dreamed you would find here. Social Events 5:00 - 6:00 p.m. 5K Run/Walk Saturday, May 2 Noon - 2:30 p.m. MAOPS/AMAOPS Joint Luncheon 7:00 - 10:30 p.m. 6:00 - 9:00 p.m. Family Fun Night on the Branson Belle! President’s Reception & Banquet The Showboat Branson Belle dinner cruise will feature live music and a fun show for Showboat Branson Belle! the whole family! Enjoy the beautiful spring weather and 6:30 - 8:00 p.m. breathtaking views of Table Rock Lake Networking Mixer for Young Physicians from the deck of the one-of-a-kind Meet and learn from a large variety of Showboat Branson Belle! specialists to help narrow your decisions This dinner cruise will feature as you get ready to launch your career. entertainment by the The ShowMen Afterwards, enjoy the sounds of Ernie and All That from America’s Got Talent! Biggs’ Dueling Pianos! Bring the whole family for a fun evening aboard the Branson Belle! 5K Run/Walk Make time for a little exercise! Come out and walk or run and enjoy the great outdoors. Proceeds support the Wetzel Foundation Scholarship Program. Physician Registration Form Exhibit Hall Events AOA# Find services that will help you in your practice Wednesday, April 29 Noon - 3:00 p.m. 5:00 - 8:00 p.m. 8:00 - 9:00 p.m. MAOPS Board Member Leadership Training MAOPS Annual Membership Meeting MAOPS Membership Reception Friday, May 1 7:30 - 9:00 a.m. MOPAC Capitol Club Recognition Breakfast Saturday, May 2 7:30 - 9:00 a.m. 3:00 - 4:00 p.m. Gavel Club Breakfast for MAOPS Past Presidents MAOPS Women Physicians Reception 8:30 - 9:30 a.m. AOA Delegates Meeting Sunday, May 3 Young Physicians Events Friday, May 1 Saturday, May 2 5:00 - 6:00 p.m. 6:30 - 8:00 p.m. 8:00 - Midnight 5K Run/Walk MAOPS Young Physicians Networking Mixer Ernie Biggs’ Dueling Pianos 9:00 a.m. - Noon MAOPS Young Physicians Training Radiology for the Non-Radiologist Relaxation Techniques Interview Preparation Who are the “Young Physicians” anyway? Can I participate in these events? Any physician in practice 10 years or less, post graduate physicians and medical school students make up the Young Physicians group. If this sounds like you, please join us! 2015 Physician Brochure for Emailing.indd 2 All meals (with the exception of Friday night) are included in the regisration fee. Please help us accurately estimate the number of meals to order by checking each meal you plan to attend. AAFP #(If applicable) Full Address: Take care of Mother’s Day shopping! Business Phone Number: Thursday ATSU Alumni Lunch Business Email Address: Please check box if we cannot share your email address with registered exhibiting firms. The Exhibit Hall at the MAOPS Annual Convention is one of the largest in the country! You will have more than six hours to visit with the 80+ exhibiting firms and learn about products and services that can help you and your patients. Plus we will have a few booths with gift-type items! Fee Options (circle the applicable fee) Early Bird Regular Late thru 3/31 4/1-4/25 after 4/25 Thursday, April 30: Enjoy time to visit with exhibiting firms and invite one or more reps to join you for dinner. This evening event is fun and relaxed. Wine and beer will be served. Intern/Resident/Student/Fellowship $95 $95 $195 1st/2nd/3rd Year Member $395 $495 $595 Friday, May 1: An extended morning break (1.5 hours) will give you time to reach more of the exhibiting firms. Be ready to win some prizes! Life/Honorary Life/Retired Member $395 $495 $595 Disabled/Hardship Member $395 $495 $595 Lunch will be served in the exhibit hall during the closing session in the exhibit hall. Stay until our last prize is given away! You can’t win unless you are in the exhibit hall! Full Member $545 $645 $745 Two-Day Member Rate $375 $475 $575 Non-Member Rate $745 $845 $945 Non-Member Two-Day Rate $600 $700 $800 Non-Member Intern/Resident/Student $235 $335 $435 Allied Health Professional (Non-Physicians) $395 $495 $595 Register your whole family! The 5K is open to everyone. Complete the 5K section on the registration form or register online. Member Meetings Registrant Meal Function Attendance Name: Learn what new products are on the market KCUMB Alumni Lunch Friday Exhibit Hall Lunch Saturday Joint Luncheon President’s Banquet Registrant Attendance Friday PM - Branson Belle Friday Family Fun Night will be on the Showboat Branson Belle. Registrants are asked to purchase their tickets in advance. Registrant Price $48 Meal Restrictions Please indicate below any food allergies or food restrictions you have. We will be sure to order a meal that meets your needs. Guest Tickets Guests are welcome to all events shown below. MAOPS has subsidized the children’s ticket prices to encourage you to bring family members to the events. Please identify the number of guest tickets you would like to purchase. (Children under 3 are free - we ask for quantity only.) How to Register Convention Registration Registration for the 117th Missouri Osteopathic Annual Convention can be submitted online through the MAOPS website, or by US mail, email or fax. Online: Go to www.maops.org and select the “CME Center” button. Navigate to the Missouri Osteopathic Annual Convention. Mail: Complete the registration form in this brochure and mail to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65101 Email: Complete the registration form in this brochure, scan it and email to Chris Bowles at ChrisB@maops.org. Fax: Use the registration form in this brochure and fax to 573.634.5635. Cancellation Policy In the event of an attendee cancellation, registration fees and guest meal ticket purchases will be refunded as follows: Prior to March 31, 2015: Full refund, less $50 admin fee April 1- April 15, 2015: Full refund, less $150 admin fee After April 15, 2015: No refund Hotel Reservations Hotel reservations at Chateau on the Lake can be made online at www.MAOPS.org. Single or double occupancy room rates (excluding sales tax) for the convention are: $169 Mountain View/Lake View Lake Front King $189 Mountain View Ambassador Suite $259 Lake Front Ambassador Suite $279 Event ATSU Luncheon KCUMB Luncheon Exhibit Hall Lunch Fun Night on Branson Belle Joint Luncheon President’s Banquet Adult Ticket $33 $33 $33 $48 $38 $60 Qty Adult ______ ______ ______ ______ ______ ______ Child Ticket n/a n/a n/a $10 $7 $7 Child Qty Ages 4-11 Child Qty Ages 0-3 ______ ______ ______ $0 $0 $0 TOTAL $ ______ ______ ______ ______ ______ ______ 16th Annual 5K Run/Walk Registration (optional) If you or your family member(s) would like to participate in the 5K Run/Walk, complete this section. If more than one person, indicate quantity next to each marked choice. Each registrant will receive a T-shirt compliments of the St. Louis District Osteopathic Association. 5K Fee Physician - $35 Non Physician - $20 Total $_______ $1,000 VISA Gift Card Raffle Ticket Purchase (optional) Yes, I would like to purchase a raffle ticket(s) to support the Wetzel Scholarship and DO Care programs: One Ticket $50 To make your hotel reservation Two Tickets $100 Four Tickets $200 Your Choice $_____ Sponsor a Student/Resident (optional) Go to www.maops.org Yes, I would like to sponsor a student or resident for convention. My tax-deductible donation amount is: $100 Click the “CME Center” button $200 $500 Your Choice $_____ Total Payment Select “Missouri Osteopathic Annual Convention” Branson Belle Registration $____ + for Registrant $____ + Guest Ticket(s) $____ + 5K Run/Walk Fee $____ + Raffle Ticket____ + Sponsorship____ = TOTAL $______ Payment Method: Select “Hotel Reservations” Check payable to: William L. Wetzel Osteopathic Foundation Credit card: OR Use this QR code Day Thursday Thursday Friday Friday Saturday Saturday Online Registration Information Reservations can also be made by calling Chateau on the Lake directly at 888.333.5253. Be sure to ask for the MAOPS rate. Card Number: Contact Phone: Name on Card: Billing Address: Mastercard Visa Discover Exp: CVC: Please return this form to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65101 or fax or email: Fax: 573.634.5635 Email to: ChrisB@maops.org 11/12/2014 10:01:23 AM Friday, May 1 Thursday, April 30 12:20 - 1:20 p.m. ATSU-KCOM Alumni Luncheon KCUMB-COM Alumni Luncheon 4:30 - 7:30 p.m. Exhibit Hall Welcome Reception Meet our exhibitors while enjoying your favorite beverage and appetizers. We have “market shoppe” exhibitors mixed in with medical exhibitors. You may find a product you never dreamed you would find here. Social Events 5:00 - 6:00 p.m. 5K Run/Walk Saturday, May 2 Noon - 2:30 p.m. MAOPS/AMAOPS Joint Luncheon 7:00 - 10:30 p.m. 6:00 - 9:00 p.m. Family Fun Night on the Branson Belle! President’s Reception & Banquet The Showboat Branson Belle dinner cruise will feature live music and a fun show for Showboat Branson Belle! the whole family! Enjoy the beautiful spring weather and 6:30 - 8:00 p.m. breathtaking views of Table Rock Lake Networking Mixer for Young Physicians from the deck of the one-of-a-kind Meet and learn from a large variety of Showboat Branson Belle! specialists to help narrow your decisions This dinner cruise will feature as you get ready to launch your career. entertainment by the The ShowMen Afterwards, enjoy the sounds of Ernie and All That from America’s Got Talent! Biggs’ Dueling Pianos! Bring the whole family for a fun evening aboard the Branson Belle! 5K Run/Walk Make time for a little exercise! Come out and walk or run and enjoy the great outdoors. Proceeds support the Wetzel Foundation Scholarship Program. Physician Registration Form Exhibit Hall Events AOA# Find services that will help you in your practice Wednesday, April 29 Noon - 3:00 p.m. 5:00 - 8:00 p.m. 8:00 - 9:00 p.m. MAOPS Board Member Leadership Training MAOPS Annual Membership Meeting MAOPS Membership Reception Friday, May 1 7:30 - 9:00 a.m. MOPAC Capitol Club Recognition Breakfast Saturday, May 2 7:30 - 9:00 a.m. 3:00 - 4:00 p.m. Gavel Club Breakfast for MAOPS Past Presidents MAOPS Women Physicians Reception 8:30 - 9:30 a.m. AOA Delegates Meeting Sunday, May 3 Young Physicians Events Friday, May 1 Saturday, May 2 5:00 - 6:00 p.m. 6:30 - 8:00 p.m. 8:00 - Midnight 5K Run/Walk MAOPS Young Physicians Networking Mixer Ernie Biggs’ Dueling Pianos 9:00 a.m. - Noon MAOPS Young Physicians Training Radiology for the Non-Radiologist Relaxation Techniques Interview Preparation Who are the “Young Physicians” anyway? Can I participate in these events? Any physician in practice 10 years or less, post graduate physicians and medical school students make up the Young Physicians group. If this sounds like you, please join us! 2015 Physician Brochure for Emailing.indd 2 All meals (with the exception of Friday night) are included in the regisration fee. Please help us accurately estimate the number of meals to order by checking each meal you plan to attend. AAFP #(If applicable) Full Address: Take care of Mother’s Day shopping! Business Phone Number: Thursday ATSU Alumni Lunch Business Email Address: Please check box if we cannot share your email address with registered exhibiting firms. The Exhibit Hall at the MAOPS Annual Convention is one of the largest in the country! You will have more than six hours to visit with the 80+ exhibiting firms and learn about products and services that can help you and your patients. Plus we will have a few booths with gift-type items! Fee Options (circle the applicable fee) Early Bird Regular Late thru 3/31 4/1-4/25 after 4/25 Thursday, April 30: Enjoy time to visit with exhibiting firms and invite one or more reps to join you for dinner. This evening event is fun and relaxed. Wine and beer will be served. Intern/Resident/Student/Fellowship $95 $95 $195 1st/2nd/3rd Year Member $395 $495 $595 Friday, May 1: An extended morning break (1.5 hours) will give you time to reach more of the exhibiting firms. Be ready to win some prizes! Life/Honorary Life/Retired Member $395 $495 $595 Disabled/Hardship Member $395 $495 $595 Lunch will be served in the exhibit hall during the closing session in the exhibit hall. Stay until our last prize is given away! You can’t win unless you are in the exhibit hall! Full Member $545 $645 $745 Two-Day Member Rate $375 $475 $575 Non-Member Rate $745 $845 $945 Non-Member Two-Day Rate $600 $700 $800 Non-Member Intern/Resident/Student $235 $335 $435 Allied Health Professional (Non-Physicians) $395 $495 $595 Register your whole family! The 5K is open to everyone. Complete the 5K section on the registration form or register online. Member Meetings Registrant Meal Function Attendance Name: Learn what new products are on the market KCUMB Alumni Lunch Friday Exhibit Hall Lunch Saturday Joint Luncheon President’s Banquet Registrant Attendance Friday PM - Branson Belle Friday Family Fun Night will be on the Showboat Branson Belle. Registrants are asked to purchase their tickets in advance. Registrant Price $48 Meal Restrictions Please indicate below any food allergies or food restrictions you have. We will be sure to order a meal that meets your needs. Guest Tickets Guests are welcome to all events shown below. MAOPS has subsidized the children’s ticket prices to encourage you to bring family members to the events. Please identify the number of guest tickets you would like to purchase. (Children under 3 are free - we ask for quantity only.) How to Register Convention Registration Registration for the 117th Missouri Osteopathic Annual Convention can be submitted online through the MAOPS website, or by US mail, email or fax. Online: Go to www.maops.org and select the “CME Center” button. Navigate to the Missouri Osteopathic Annual Convention. Mail: Complete the registration form in this brochure and mail to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65101 Email: Complete the registration form in this brochure, scan it and email to Chris Bowles at ChrisB@maops.org. Fax: Use the registration form in this brochure and fax to 573.634.5635. Cancellation Policy In the event of an attendee cancellation, registration fees and guest meal ticket purchases will be refunded as follows: Prior to March 31, 2015: Full refund, less $50 admin fee April 1- April 15, 2015: Full refund, less $150 admin fee After April 15, 2015: No refund Hotel Reservations Hotel reservations at Chateau on the Lake can be made online at www.MAOPS.org. Single or double occupancy room rates (excluding sales tax) for the convention are: $169 Mountain View/Lake View Lake Front King $189 Mountain View Ambassador Suite $259 Lake Front Ambassador Suite $279 Event ATSU Luncheon KCUMB Luncheon Exhibit Hall Lunch Fun Night on Branson Belle Joint Luncheon President’s Banquet Adult Ticket $33 $33 $33 $48 $38 $60 Qty Adult ______ ______ ______ ______ ______ ______ Child Ticket n/a n/a n/a $10 $7 $7 Child Qty Ages 4-11 Child Qty Ages 0-3 ______ ______ ______ $0 $0 $0 TOTAL $ ______ ______ ______ ______ ______ ______ 16th Annual 5K Run/Walk Registration (optional) If you or your family member(s) would like to participate in the 5K Run/Walk, complete this section. If more than one person, indicate quantity next to each marked choice. Each registrant will receive a T-shirt compliments of the St. Louis District Osteopathic Association. 5K Fee Physician - $35 Non Physician - $20 Total $_______ $1,000 VISA Gift Card Raffle Ticket Purchase (optional) Yes, I would like to purchase a raffle ticket(s) to support the Wetzel Scholarship and DO Care programs: One Ticket $50 To make your hotel reservation Two Tickets $100 Four Tickets $200 Your Choice $_____ Sponsor a Student/Resident (optional) Go to www.maops.org Yes, I would like to sponsor a student or resident for convention. My tax-deductible donation amount is: $100 Click the “CME Center” button $200 $500 Your Choice $_____ Total Payment Select “Missouri Osteopathic Annual Convention” Branson Belle Registration $____ + for Registrant $____ + Guest Ticket(s) $____ + 5K Run/Walk Fee $____ + Raffle Ticket____ + Sponsorship____ = TOTAL $______ Payment Method: Select “Hotel Reservations” Check payable to: William L. Wetzel Osteopathic Foundation Credit card: OR Use this QR code Day Thursday Thursday Friday Friday Saturday Saturday Online Registration Information Reservations can also be made by calling Chateau on the Lake directly at 888.333.5253. Be sure to ask for the MAOPS rate. Card Number: Contact Phone: Name on Card: Billing Address: Mastercard Visa Discover Exp: CVC: Please return this form to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65101 or fax or email: Fax: 573.634.5635 Email to: ChrisB@maops.org 11/12/2014 10:01:23 AM Purchase your ad in the 2015 Yearbook today! Either complete this form and send to MAOPS with your convention registration, or navigate to the website and pay online. Send your prepared ad (.pdf format) or your ad wording and layout to Glenda Accardo at glenda.is@me.com by Feb. 28, 2015. Include electronic photos you would like to use in your ad. Convention Guide Ad Purchase Ad Size (please circle): Business card - $50 Half page - $200 Quarter page - $100 Full page - $400 Send your ad specifications or prepared ad to: Glenda Accardo at glenda.is.@me.com Payment Method Check payable to: AMAOPS Credit card Mastercard Purchaser Name/Name on Card Billing Address on Card Send your ad payment to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65101 Visa Discover Card Number Expiration Date CVC # (3 digits on back) $1,000 VISA Gift Card Raffle MAOPS and AMAOPS are combining efforts to raise funds for the Wetzel Foundation Scholarship Program and DO Care Program! Buy one or more $50 raffle tickets for your chance to win a $1,000 VISA gift card. Drawing will take place at the Joint Luncheon on Sat. May 2, 2015. $50 Raffle Tickets Join Us MOAC Yearbook The Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons is excited to bring you the 2015 Yearbook! This full color online book is the perfect place to congratulate new MAOPS or AMAOPS officers, to recognize your mentors from medical school or during residency and to remember great times celebrated with the osteopathic family. Continuing Medical Education The Continuing Medical Education program features a Family Medicine track and an Internal Medicine track. The Chateau on the Lake April 29 - May 3, 2015 in Branson, Missouri Do not need to be present to win...but we would love to have you there! AMAOPS Schedule of Events Dr. Fillingane is a family physician practicing in Mississippi. Early in his career, three of Dr. Fillingane’s patients died from heart attacks over a period of 10 days. It was then that Dr. Fillingane vowed to do whatever he could to reduce cardiovascular risk in his patients. Saturday, May 2 Noon - 2:30 p.m. 6:00 - 9:00 p.m. AMAOPS Registration Full Name Address MAOPS/AMAOPS Joint Luncheon MAOPS President’s Reception & Banquet City State Invitation to Join AMAOPS AMAOPS is the Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons. Our objective is to unite all interested persons of osteopathic physicians for the purpose of creating a better understanding of osteopathic medicine among lay people. Thus, aiding in the improvement of public health. Zip Phone Email Join us for our Annual Membership Meeting! We would like to get to know you and work together in the future for osteopathic medicine! I am interested in becoming a member of the Auxiliary to the Missouri Association of Osteopathic Physicians and Surgeons (AMAOPS). Please contact me. I will be attending the AMAOPS Annual Membership Meeting on Friday, May 1, 2015. 2015 Physician Brochure for Emailing.indd 1 Mail your form to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65109 Keynote Speakers Beating Cardiovascular Disease AMAOPS Membership Meeting AMAOPS Past Presidents’ Luncheon Family Fun Night on Branson Belle Thursday, April 30: 7:00 a.m. - 4:30 p.m. Saturday, May 2: 7:00 a.m. - 4:45 p.m. FM & IM: Cardiovascular Disease Beating Cardiovascular Disease Sam Fillingane, DO FM & IM: Diabetes Classifying and Treating Diabetes Sam Fillingane, DO FM & IM: Congestive Heart Failure Management Decompensated CHF - The Emergent Patient Decompensated CHF - The Hospitalized Patient CHF - The Patient Being Discharged John Grider, DO Update in CHF Device Therapy Jessica Birchem, DO, FACC Cor Pulmonale & Pulmonary Hypertension Bill Galli, DO Post-Discharge and Chronic Outpatient CHF Management: Decreasing Admissions & Readmissions Christopher Veremakis, MD Friday, May 1: 7:00 a.m. - 5:15 p.m. AMAOPS Registration & Schedule Friday, May 1 9:30 a.m. - Noon 12:30 - 1:30 p.m. 7:00 - 10:30 p.m. Schedule of Events 117th Missouri Osteopathic Annual Convention Dr. Fillingane began his research and ultimately found that cardiovascular disease is a disease of inflammation that is caused by eight major disease state categories. By using a carefully guided history and physical, along with advanced cardiovascular lab and office testing and by treating each of the eight disease states from an inflammatory perspective, Dr. Fillingane has achieved amazing results. Recently, an outside organization data mined Dr. Fillingane’s patient cases over an eight-year period. While Dr. Fillingane practices in a state with one of the highest per capita cardiovascular event rates in the country, and while Dr. Fillingane’s patient population is made up entirely of high-risk patients with cardiovascular disease, the organization reported that Dr. Fillingane had a total of 1.2 heart attack patients per year, and there were no stroke occurrences over the last five years of the eight-year period studied. Sam Fillingane, DO Dr. Fillingane’s techniques of care are innovating progress being made in prevention of heart attacks and strokes. Come and learn Dr. Fillingane’s techniques so you, too, can beat cardiovascular disease in your patients. Bringing the Joy Back to the Practice of Medicine Joint Luncheon Guest Speaker Dr. Anderson’s new concept for providing better care meets the “perfect storm” of challenges confronting family practices today - an aging population, millions of newly insured coming into the system, new regulations, higher costs and lower reimbursements. Dr. Anderson’s message will help you once again feel the joy of practicing medicine. Join us to hear Dr. Anderson at the Joint Luncheon. FM: Ortho Pearls Fractures - What Can You Take Care Sam Fillingane, DO of in the Office? BEATING CARDIOVASCULAR Thomas Berkbigler, DO DISEASE MAOPS/AMAOPS Joint Luncheon Splint Lab MAOPS/AMAOPS JOINT FM & IM: Bringing the Joy Back to the John Bailey, DO, CLASSIFYING & TREATING LUNCHEON SPEAKER Practice of Medicine Thomas Berkbigler, DO, DIABETES Peter Anderson, MD Charles Orth, DO, Justin Puckett, DO Upper Extremity Pain and Management FM: Preventive Medicine Charles Orth, DO Wellness Exams Injection Lab Justin Puckett, DO John Bailey, DO, Thomas Berkbigler, DO, Genetic Counseling Charles Orth, DO, Justin Puckett, DO Bronson Riley, MS FM: Neuro Topics Adult Immunizations Headache Management Peter Anderson, MD Lana Hudanick, RN, BSN Roger Cady, MD IM: In-Patient Situations Tremors BRINGING THE JOY BACK TO Establishing Patient Competency Vikas Kumar, MD, PhD THE PRACTICE OF MEDICINE Ozark Center The Dementias Against Medical Advice Ozark Center Timothy Reuschel, JD Obstructive Sleep Apnea Juan Mella, MD Pharmacologic Induced Neurologic Disorders Constanza Martinez, MD IM: Miscellaneous Sunday, May 3: 7:00 a.m. - 11:00 a.m. Hypothermia & Hypothermia Cases IM: Focused on In-Patient Specialties FM: Technology in the Office David Tannehill, DO Infectious Disease - Antibiotic Social Media & Apps that Matter EKG Refresher & Arrhythmia Management Stewardship Michael Brown, DO Walter Coats, DO Bridget Bransteitter, DO Meaningful Use IM: Blood, Blood Clots & Bloody Messes Pulmonary Grab Bag Larry Henderson, BBA, CHPS Blood Transfusions Bill Galli, DO Primaris David Tannehill, DO Mixed Acid Base Cases Patient Portals Hypercoaguability & Acute Venous Thromboembolism Steven Thiel, MD Michael Brown, DO Chris Heuser, DO Managing In-Patient Psych Patient Hematology in the Trauma Patient & Delirium Kevin Hubbard, DO, FACOI Todd Hill, DO Surviving Sepsis Campaign Guideline Update & the Impact of the ProCESS Trial David Tannehill, DO Tentative schedule: Topics and presenters subject to change And More! AOA Update Code Status and End of Life Discussion E-Prescribing Pros & Cons of Various EHRs Primary care physicians across the country are struggling with lower revenue, longer hours and the feeling that they are unable to provide the kind of care they have in the past. Dr. Anderson knows this because he felt it - he lived it. In 2003, he developed a better way to manage his office and in doing so, he saved his practice and brought the joy back to the practice of medicine. KEYNOTE SPEAKER Please Note: Nurses, advanced-practice nurses, physician assistants and other allied healthcare professionals are welcome to attend the Missouri Osteopathic Annual Convention. Please share this brochure with the collaborating providers in your office. MAOPS has requested that the AOA Council on Continuing Medical Education approve this program for 43.5 AOA Category 1-A CME credits. Approval is currently pending for 26 AAFP Prescribed Credits with the AAFP Commission on Continuing Professional Development (COCPD). Peter Anderson, MD MAOPS has requested that the American College of Osteopathic Internists approve this program for 25 Category 1-A Internal Medicine specialist credits. 11/12/2014 10:01:17 AM Friday, May 1 Thursday, April 30 12:20 - 1:20 p.m. ATSU-KCOM Alumni Luncheon KCUMB-COM Alumni Luncheon 4:30 - 7:30 p.m. Exhibit Hall Welcome Reception Meet our exhibitors while enjoying your favorite beverage and appetizers. We have “market shoppe” exhibitors mixed in with medical exhibitors. You may find a product you never dreamed you would find here. Social Events 5:00 - 6:00 p.m. 5K Run/Walk Saturday, May 2 Noon - 2:30 p.m. MAOPS/AMAOPS Joint Luncheon 7:00 - 10:30 p.m. 6:00 - 9:00 p.m. Family Fun Night on the Branson Belle! President’s Reception & Banquet The Showboat Branson Belle dinner cruise will feature live music and a fun show for Showboat Branson Belle! the whole family! Enjoy the beautiful spring weather and 6:30 - 8:00 p.m. breathtaking views of Table Rock Lake Networking Mixer for Young Physicians from the deck of the one-of-a-kind Meet and learn from a large variety of Showboat Branson Belle! specialists to help narrow your decisions This dinner cruise will feature as you get ready to launch your career. entertainment by the The ShowMen Afterwards, enjoy the sounds of Ernie and All That from America’s Got Talent! Biggs’ Dueling Pianos! Bring the whole family for a fun evening aboard the Branson Belle! 5K Run/Walk Make time for a little exercise! Come out and walk or run and enjoy the great outdoors. Proceeds support the Wetzel Foundation Scholarship Program. Physician Registration Form Exhibit Hall Events AOA# Find services that will help you in your practice Wednesday, April 29 Noon - 3:00 p.m. 5:00 - 8:00 p.m. 8:00 - 9:00 p.m. MAOPS Board Member Leadership Training MAOPS Annual Membership Meeting MAOPS Membership Reception Friday, May 1 7:30 - 9:00 a.m. MOPAC Capitol Club Recognition Breakfast Saturday, May 2 7:30 - 9:00 a.m. 3:00 - 4:00 p.m. Gavel Club Breakfast for MAOPS Past Presidents MAOPS Women Physicians Reception 8:30 - 9:30 a.m. AOA Delegates Meeting Sunday, May 3 Young Physicians Events Friday, May 1 Saturday, May 2 5:00 - 6:00 p.m. 6:30 - 8:00 p.m. 8:00 - Midnight 5K Run/Walk MAOPS Young Physicians Networking Mixer Ernie Biggs’ Dueling Pianos 9:00 a.m. - Noon MAOPS Young Physicians Training Radiology for the Non-Radiologist Relaxation Techniques Interview Preparation Who are the “Young Physicians” anyway? Can I participate in these events? Any physician in practice 10 years or less, post graduate physicians and medical school students make up the Young Physicians group. If this sounds like you, please join us! 2015 Physician Brochure for Emailing.indd 2 All meals (with the exception of Friday night) are included in the regisration fee. Please help us accurately estimate the number of meals to order by checking each meal you plan to attend. AAFP #(If applicable) Full Address: Take care of Mother’s Day shopping! Business Phone Number: Thursday ATSU Alumni Lunch Business Email Address: Please check box if we cannot share your email address with registered exhibiting firms. The Exhibit Hall at the MAOPS Annual Convention is one of the largest in the country! You will have more than six hours to visit with the 80+ exhibiting firms and learn about products and services that can help you and your patients. Plus we will have a few booths with gift-type items! Fee Options (circle the applicable fee) Early Bird Regular Late thru 3/31 4/1-4/25 after 4/25 Thursday, April 30: Enjoy time to visit with exhibiting firms and invite one or more reps to join you for dinner. This evening event is fun and relaxed. Wine and beer will be served. Intern/Resident/Student/Fellowship $95 $95 $195 1st/2nd/3rd Year Member $395 $495 $595 Friday, May 1: An extended morning break (1.5 hours) will give you time to reach more of the exhibiting firms. Be ready to win some prizes! Life/Honorary Life/Retired Member $395 $495 $595 Disabled/Hardship Member $395 $495 $595 Lunch will be served in the exhibit hall during the closing session in the exhibit hall. Stay until our last prize is given away! You can’t win unless you are in the exhibit hall! Full Member $545 $645 $745 Two-Day Member Rate $375 $475 $575 Non-Member Rate $745 $845 $945 Non-Member Two-Day Rate $600 $700 $800 Non-Member Intern/Resident/Student $235 $335 $435 Allied Health Professional (Non-Physicians) $395 $495 $595 Register your whole family! The 5K is open to everyone. Complete the 5K section on the registration form or register online. Member Meetings Registrant Meal Function Attendance Name: Learn what new products are on the market KCUMB Alumni Lunch Friday Exhibit Hall Lunch Saturday Joint Luncheon President’s Banquet Registrant Attendance Friday PM - Branson Belle Friday Family Fun Night will be on the Showboat Branson Belle. Registrants are asked to purchase their tickets in advance. Registrant Price $48 Meal Restrictions Please indicate below any food allergies or food restrictions you have. We will be sure to order a meal that meets your needs. Guest Tickets Guests are welcome to all events shown below. MAOPS has subsidized the children’s ticket prices to encourage you to bring family members to the events. Please identify the number of guest tickets you would like to purchase. (Children under 3 are free - we ask for quantity only.) How to Register Convention Registration Registration for the 117th Missouri Osteopathic Annual Convention can be submitted online through the MAOPS website, or by US mail, email or fax. Online: Go to www.maops.org and select the “CME Center” button. Navigate to the Missouri Osteopathic Annual Convention. Mail: Complete the registration form in this brochure and mail to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65101 Email: Complete the registration form in this brochure, scan it and email to Chris Bowles at ChrisB@maops.org. Fax: Use the registration form in this brochure and fax to 573.634.5635. Cancellation Policy In the event of an attendee cancellation, registration fees and guest meal ticket purchases will be refunded as follows: Prior to March 31, 2015: Full refund, less $50 admin fee April 1- April 15, 2015: Full refund, less $150 admin fee After April 15, 2015: No refund Hotel Reservations Hotel reservations at Chateau on the Lake can be made online at www.MAOPS.org. Single or double occupancy room rates (excluding sales tax) for the convention are: $169 Mountain View/Lake View Lake Front King $189 Mountain View Ambassador Suite $259 Lake Front Ambassador Suite $279 Event ATSU Luncheon KCUMB Luncheon Exhibit Hall Lunch Fun Night on Branson Belle Joint Luncheon President’s Banquet Adult Ticket $33 $33 $33 $48 $38 $60 Qty Adult ______ ______ ______ ______ ______ ______ Child Ticket n/a n/a n/a $10 $7 $7 Child Qty Ages 4-11 Child Qty Ages 0-3 ______ ______ ______ $0 $0 $0 TOTAL $ ______ ______ ______ ______ ______ ______ 16th Annual 5K Run/Walk Registration (optional) If you or your family member(s) would like to participate in the 5K Run/Walk, complete this section. If more than one person, indicate quantity next to each marked choice. Each registrant will receive a T-shirt compliments of the St. Louis District Osteopathic Association. 5K Fee Physician - $35 Non Physician - $20 Total $_______ $1,000 VISA Gift Card Raffle Ticket Purchase (optional) Yes, I would like to purchase a raffle ticket(s) to support the Wetzel Scholarship and DO Care programs: One Ticket $50 To make your hotel reservation Two Tickets $100 Four Tickets $200 Your Choice $_____ Sponsor a Student/Resident (optional) Go to www.maops.org Yes, I would like to sponsor a student or resident for convention. My tax-deductible donation amount is: $100 Click the “CME Center” button $200 $500 Your Choice $_____ Total Payment Select “Missouri Osteopathic Annual Convention” Branson Belle Registration $____ + for Registrant $____ + Guest Ticket(s) $____ + 5K Run/Walk Fee $____ + Raffle Ticket____ + Sponsorship____ = TOTAL $______ Payment Method: Select “Hotel Reservations” Check payable to: William L. Wetzel Osteopathic Foundation Credit card: OR Use this QR code Day Thursday Thursday Friday Friday Saturday Saturday Online Registration Information Reservations can also be made by calling Chateau on the Lake directly at 888.333.5253. Be sure to ask for the MAOPS rate. Card Number: Contact Phone: Name on Card: Billing Address: Mastercard Visa Discover Exp: CVC: Please return this form to: Wetzel Foundation 1423 Randy Lane Jefferson City, MO 65101 or fax or email: Fax: 573.634.5635 Email to: ChrisB@maops.org 11/12/2014 10:01:23 AM