2022 Pediatrics Courses

A. Identification

Salutation:

First Name:*

Last Name:*

Title/Position:

Department/Division:

Organization:

Address:*

City:*

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Country:*

Telephone:*

Mobile:

Fax:

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Where did you hear about these courses?

Professional Status*

Resident MD Nurse Other

Medical Speciality:

Professional License Number

Please check here if you do not want your email address to appear on the list of participants which may be distributed to participants.

B. Concurrent Sessions - PEDIATRIC SURGERY

Session 1 - Choose either A or B

Choice:	Name
	A : Clicks and Twists: Orthopedic Problems of the Neonate and Infant
	B : Too Wet: Evaluation and Management of the Drooling Child

Session 2 - Choose either C or D

Choice:	Name
	C : Front and Back: Scoliosis and Chest Wall Anomalies
	D : Over the Top: Head and Neck Lesions in Children

Session 3 - Choose either E or F

Choice:	Name
	E : Crooked Heads: Plagiocephaly and Synostosis
	F : The Child Whose Belly Hurts

B. Concurrent Sessions - PRACTICAL PROBLEMS

Session 1 - Choose either A or B

Choice:	Name
	A : Aftershocks: Adolescent Mental Health in the Era of COVID-19
	B : Worth a Thousand Words: Speech and Language Difficulties in Children

Session 2 - Choose either C or D

Choice:	Name
	C : Get “Back” Into It: An Approach to Pediatric Back Pain
	D : Clumsy Child or Something Else? Hypotonia in School-Aged Youth

Session 3 - Choose either E or F

Choice:	Name
	E : Choosing Wisely: Promoting Conversations Between Patients and Clinicians
	F : S.O.S. Doctors in Distress!

C. Registration Fees

For Physicians
	Pediatric Surgery Feb. 9, 2022	Practical Problems in Pediatrics Feb. 10-11, 2022	Both Courses Feb. 9, 10, 11 2022
Early Bird: Before Jan. 7, 2022	$310	$530	$725
Regular: After Jan. 7, 2022	$350	$585	$800

For Nurses or Residents
	Pediatric Surgery Feb. 9, 2022	Practical Problems in Pediatrics Feb. 10-11, 2022	Both Courses Feb. 9, 10, 11 2022
Early Bird: Before Jan. 7, 2022	$195	$345	$460
Regular: After Jan. 7, 2022	$250	$375	$485

For Invited Speakers
Click if you are an invited speaker		$0

Cancellation Policy

Full refunds, less an administrative fee of $50.00, will be made for written cancellations received by January 7, 2022. After January 7, 2022, only 50% will be refunded, and no refunds will be issued for cancellations received after February 4, 2022.

I have read and acknowledge the cancellation policy.

D. Method of Payment

Total Amount : $

	Online Credit Card Payment (VISA, Mastercard, Discover, American Express, Diners Club, Carte Blanche, JCB and Visa Debit)
	Certified Cheque/Money Order/Bank Draft (Please make payable in Canadian funds to "O'Donoughue & Associates Event Management Re : Pediatric Courses")
	Credit Card Payment by Fax

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Registration Form