Registration Form

A. Identification

Professional Status*

Medical Speciality:
Professional License Number

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
Regular:
After
Jan. 7, 2022

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
Regular:
After
Jan. 7, 2022

For Invited Speakers
Click if you are an invited speaker          



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