2020 Pediatrics Courses

A. Identification

Salutation:

First Name:*

Last Name:*

Title/Position:

Department/Division:

Organization:

Address:*

City:*

Province/State:*

Postal/ZIP Code:*

Country:*

Telephone:*

Mobile:

Fax:

E-mail:*

Where did you hear about these courses?

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. Special Needs

Please indicate any special needs (dietary, wheelchair access, etc.):

C. Workshop Preferences

ANNUAL SPECIALTY DAY: Baby Basics: Infant Health from Head to Toe

February 12, 2020

SESSIONS I to III

Please rank the workshops in order of preference (1 to 6). You will be assigned to 3 workshops on a first-come, first-reserved basis.

Choice:	Workshop Name:
	Neonatal Resuscitation Program (NRP) Refresher
	Head to Toe - What Not to Miss on the Newborn Exam
	Baby Formulas - Options and Evidence
	Deliver with Care - Review of Newborn Birth Trauma
	Approach to the Blue Baby
	Neonatal Rash Review

PRACTICAL PROBLEMS IN PEDIATRICS

February 13, 2020

Please rank the workshops in order of preference (1 to 6). You will be assigned to 3 workshops on a first-come, first-reserved basis.

Choice:	Workshop Name:
	X-ray Rounds
	The Challenges of Adolescent ADHD
	Scrapes and Breaks - Managing Minor Trauma in the Office
	Go with the Flow - Menorrhagia Management
	Dealing with a Picky Eater
	How Is Climate Change Affecting the Health of Our Children?

D. Registration Fees

For Physicians
	Baby Basics: Infant Health from Head to Toe Feb. 12, 2020	Practical Problems in Pediatrics Feb. 13-14, 2020	Both Courses Feb. 12-14, 2020
Early Bird: Before Dec. 16, 2019	$370	$615	$840
Regular: After Dec. 16, 2019	$410	$680	$930

For Nurses or Residents
	Baby Basics: Infant Health from Head to Toe Feb. 12, 2020	Practical Problems in Pediatrics Feb. 13-14, 2020	Both Courses Feb. 12-14, 2020
Early Bird: Before Dec. 16, 2019	$295	$400	$535
Regular: After Dec. 16, 2019	$320	$430	$565

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

On-site registration*
....................	Baby Basics: Infant Health from Head to Toe Feb. 12, 2020	Practical Problems in Pediatrics Feb. 13-14, 2020	Both Courses Feb. 12-14, 2020
After Feb. 1, 2020	$435	$740	$1,030
A one-day registration for the Practical Problems in Pediatrics Course is $410. After Feb 1, 2020 one-day registration is $435.00. Early Bird is before December 16, 2019. After December 16, 2019, prices revert to Regular. *After February 1, 2020, registration will be done on site. On-site registrants will be assigned workshops on the basis of availability.

E. Meet the Expert

I wish to attend the following Meet the Expert lunchtime session(s) (cost $45 per session; space is limited; first-come, first served):

Thursday, Feb. 13, 2020	ADHD/Psychiatry Closed ... OR ... Gynecology Remove Choice	$

Friday, Feb. 14, 2020	Gastroenterology ... OR ... Hematology Remove Choice	$

Meet the Expert Fees: $

Cancellation Policy

Full refunds, less an administrative fee of $50.00, will be made for written cancellations received by January 10, 2020. After January 10, 2020, only 50% will be refunded, and no refunds will be issued for cancellations received after February 1, 2020.

I have read and acknowledge the cancellation policy.

F. Method of Payment

Total Amount (Registration Fee + Meet the Expert): $

	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