peldiatric refresher 2010 proof 4 - med.uottawa.ca€¦ · the westin ottawa has many amenities...

2
Course Credits “This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification program of the Royal College of Physicians and Surgeons of Canada.” [ MOC (Section 1) Award of 12.5 credits] “This program meets the accreditation criteria of the College of Family Physicians of Canada.” [12.5 Mainpro-M1 credits] This program has been reviewed and approved by the University of Ottawa, Office of Continuing Medical Education. Course Description This course has been designed to provide opportunities for family physicians and community based pediatricians to discuss and reflect on new developments in the care of children and adolescents. Participants will be able to interact with their colleagues on a wide variety of practical issues in a comfortable and supportive learning environment. Through large group lectures and small group, case- based seminars, participants will be able to discuss and apply new knowledge and skills and determine specific changes for their practice setting. We gratefully acknowledge the support of Exhibitors (pharmaceutical companies) ABBOTT LABORATORIES SANOFI PASTEUR INC. FERRING INC. Elsevier Canada (Login Canada) Publisher Exhibit Booth staffed by CHEO Library Services on Friday, December 3rd. DR. JUDITH ALLANSON Professor of Pediatrics, University of Ottawa Chief, Department of Genetics, CHEO DR. JENNIFER BEECKER Assistant Professor, University of Ottawa Division of Dermatology ROXANE BELANGER Speech Language Pathologist First Words, The Preschool Speech and Language Program, Ottawa DR. MATTHEW BROMWICH Assistant Professor, University of Ottawa Division of Otolaryngology, Head and Neck Surgery, CHEO DR. JASON BROPHY Assistant Professor, University of Ottawa Division of Infectious Diseases, CHEO DR. PRANESH CHAKRABORTY Assistant Professor, University of Ottawa Metabolic Geneticist/Laboratory Director Department of Genetics/Ontario Newborn Screening Program DALE DALGLEISH, RN Department of Pediatric Emergency Medicine, CHEO DR. STASIA HADJIYANNAKIS Assistant Professor, University of Ottawa, CHEO Chief, Division of Pediatric Endocrinology and Metabolism DR. PAUL HENDRY Assistant Dean, Continuing Medical Education, University of Ottawa Member, C.M.E. Committee, University of Ottawa DR. THÉRÈSE HODGSON Division of Family Medicine Member, C.M.E. Committee, University of Ottawa DR. CHARLES HUI Assistant Professor, University of Ottawa Division of Pediatric Infectious Diseases, CHEO Member, C.M.E. Committee, University of Ottawa DR. DAVID HUOT Clinical Lecturer, Division of Pediatric Community Medicine, Department of Pediatrics, CHEO Member, C.M.E. Committee, University of Ottawa DR. MONA JABBOUR Associate Professor of Pediatrics, University of Ottawa Chief, Division of Pediatric Emergency Medicine, CHEO DR. LOU LAWTON Associate Professor, Department of Surgery, University of Ottawa Division of Pediatric Orthopedic Surgery, CHEO DR. JAMES MCCONVILLE Division of Pediatric Community Medicine, Department of Pediatrics, CHEO Member, C.M.E. Committee, University of Ottawa DR. ASHA NAIR Assistant Professor, University of Ottawa Division of Developmental Pediatrics, CHEO Member, C.M.E. Committee, University of Ottawa DR. MARK NORRIS Assistant Professor of Pediatrics, University of Ottawa Regional Eating Disorders Program and Adolescent Health, CHEO DR. STEPHEN NOSEWORTHY Assistant Professor, University of Ottawa Division of Pediatric Emergency Medicine, CHEO DR. ANDREW PIPE Professor, Department of Family Medicine and Division of Cardiac Surgery, Director, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute DR. ANITA POZGAY Assistant Professor, University of Ottawa Department of Emergency Medicine, The Ottawa Hospital Dip Sport Med, Ottawa Sport Medicine Centre DR. SARAH REID Assistant Professor, University of Ottawa Division of Pediatric Emergency Medicine, CHEO Chair, Continuing Medical Education DR. ANNE ROWAN-LEGG Assistant Professor, University of Ottawa Division of Pediatric Medicine, CHEO DR. LINDY SAMSON Associate Professor of Pediatrics, University of Ottawa Division of Pediatric Infectious Diseases, CHEO DR. DEREK WONG Assistant Professor, University of Ottawa, Division of Cardiology, CHEO DR. MARC ZUCKER Assistant Professor, University of Ottawa Division of Pediatric Medicine, CHEO DR. SARAH SHEA Associate Professor, Department of Pediatrics, Dalhousie and Director of Pediatric Undergraduate Medical Education, Halifax, NS Faculty Guest Faculty Registration Fees Physicians: Early $400.00 (daily rate $275) Late: (after November 5th) $425.00 Nurses: Early $200.00 (daily rate $150) Late: (after November 5th) $240.00 Residents: $75 (daily rate: $50) Refunds (less $50.00 service charge) will be made only on cancellations received by Friday, November 5th, 2010. Accommodation This Course will be held at: The Westin Ottawa 11 Colonel By Drive, Ottawa K1N 9H4 Reservations: 613-560-7000 Fax: 613-234-5396 For special room rates $189 plus tax. (Single/Double) by October 31, 2010. Mention – “Children’s Hospital of Eastern Ontario” – Pediatric Refresher Course. Registrants are requested to book directly with the Hotel. Enquiries: Louise Lafleur, Coordinator Office of Continuing Medical Education Children’s Hospital of Eastern Ontario, Ottawa, Canada K1H 8L1 Tel.: 613-737-2285 FAX: 613-738-4297 E-mail: lafl[email protected] THE ANNUAL PAEDIATRIC REFRESHER COURSE DECEMBER 3 and 4, 2010 ~ The Westin Ottawa Ottawa, Ontario, Canada 35 th ANNUAL PAEDIATRIC REFRESHER COURSE DECEMBER 3 and 4, 2010 ~ The Westin Ottawa Ottawa, Ontario, Canada 35 th Course Objectives After attending this course, participants will be able to: Identify and manage common and important medical problems in children and youth. Reflect on practice in light of new developments in the care of children and youth, and decide whether a change in practice is appropriate. Specific objectives for each session will be described by the presenter. Target Audience Pediatricians, Family Physicians, Pediatric and Family Medicine Residents, Nurses, Nurse Practitioners, and other Health Professionals interested in Child Health. The Royal College of Physicians and Surgeons of Canada, Region 3 Advisory Committee, has provided a continuing education grant in support of our meeting. Planning Committee Dr. Sarah Reid, Dr. Mona Jabbour, Dr. Paul Hendry, Dr. Thérèse Hodgson, Dr. Chuck Hui, Dr. David Huot, Dr. Asha Nair, Dr. Jim McConville Program of Continuing Medical Education, Children’s Hospital of Eastern Ontario Faculty of Medicine, University of Ottawa Seminars Please number in order of preference. PLEASE MAKE CHOICES IN EACH SESSION 5 Seminars to choose from (repeated x1): Session #1 Morning and Session #2 Afternoon Remember to register early. Seminars are limited and assigned on a first come, first served basis. Please log onto our web site to view workshop/plenary descriptions www.pediatrics.uottawa.ca, Medical Education Friday, December 3, 2010 1100–1200 SEMINARS – Session #1 repeated in Session #2 @ 1400–1500 hrs. ___ A TALK BY 2: Know the signs. Act early. Roxane Bélanger Early identification and intervention of Speech and Language Delays ___ B Pediatric Globetrotters—Pre and Post-Travel Care for Children Dr. Jason Brophy ___ C “Kicking Butts”: Smoking Cessation Strategies for Adolescents Dr. Andrew Pipe and Dr. Mark Norris ___ D Pediatric Sports=Injuries: How are children different? Dr. Anita Pozgay ___ E Who’s in shock here, the patient or the office staff? Dr. Steve Noseworthy and Office Emergency Preparedness Using HiFi Simulation Dale Dalgleish, RN **NB: enrollment limited to 10 per session** Saturday, December 4, 2010 1130–1230 SEMINARS – Session #1 repeated in Session #2 @ 1330–1430 hrs. ___ F Pediatric Dermatology Review Dr. Jennifer Beecker ___ G When to Refer to Peds Ortho Dr. Lou Lawton ___ H Tackling Childhood Obesity in the Clinical Setting Dr. Stasia Hadjiyannakis ___ I ENT Emergencies Dr. Matthew Bromwich ___ J Tales from the Cardiology Clinic Dr. Derek Wong Mail or Fax to: Ms. Louise Lafleur, Coordinator, Continuing Medical Education Children’s Hospital of Eastern Ontario 401 Smyth Road, OTTAWA, CANADA K1H 8L1 TEL.: 613-737-2285 FAX: 613-738-4297

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Page 1: Peldiatric Refresher 2010 Proof 4 - med.uottawa.ca€¦ · The Westin Ottawa has many amenities available: gym, spa services, indoor salt water pool, whirlpool, squash courts, etc

Course Credits“This event is an Accredited Group Learning Activity (Section 1) as

defi ned by the Maintenance of Certifi cation program of the Royal

College of Physicians and Surgeons of Canada.” [ MOC (Section 1)

Award of 12.5 credits] “This program meets the accreditation criteria

of the College of Family Physicians of Canada.” [12.5 Mainpro-M1

credits] This program has been reviewed and approved by the

University of Ottawa, Offi ce of Continuing Medical Education.

Course DescriptionThis course has been designed to provide opportunities for family

physicians and community based pediatricians to discuss and

refl ect on new developments in the care of children and adolescents.

Participants will be able to interact with their colleagues on a wide

variety of practical issues in a comfortable and supportive learning

environment. Through large group lectures and small group, case-

based seminars, participants will be able to discuss and apply

new knowledge and skills and determine specifi c changes for their

practice setting.

We gratefully acknowledge the support of

Exhibitors (pharmaceutical companies)

ABBOTT LABORATORIES SANOFI PASTEUR INC.

FERRING INC.

Elsevier Canada (Login Canada) Publisher

Exhibit Booth staffed by CHEO Library Services on Friday, December 3rd.

DR. JUDITH ALLANSONProfessor of Pediatrics, University of OttawaChief, Department of Genetics, CHEO

DR. JENNIFER BEECKERAssistant Professor, University of OttawaDivision of Dermatology

ROXANE BELANGERSpeech Language PathologistFirst Words, The Preschool Speech and Language Program, Ottawa

DR. MATTHEW BROMWICHAssistant Professor, University of OttawaDivision of Otolaryngology, Head and Neck Surgery, CHEO

DR. JASON BROPHYAssistant Professor, University of OttawaDivision of Infectious Diseases, CHEO

DR. PRANESH CHAKRABORTYAssistant Professor, University of OttawaMetabolic Geneticist/Laboratory DirectorDepartment of Genetics/Ontario Newborn Screening Program

DALE DALGLEISH, RNDepartment of Pediatric Emergency Medicine, CHEO

DR. STASIA HADJIYANNAKISAssistant Professor, University of Ottawa, CHEOChief, Division of Pediatric Endocrinology and Metabolism

DR. PAUL HENDRYAssistant Dean, Continuing Medical Education, University of OttawaMember, C.M.E. Committee, University of Ottawa

DR. THÉRÈSE HODGSONDivision of Family MedicineMember, C.M.E. Committee, University of Ottawa

DR. CHARLES HUIAssistant Professor, University of OttawaDivision of Pediatric Infectious Diseases, CHEOMember, C.M.E. Committee, University of Ottawa

DR. DAVID HUOTClinical Lecturer, Division of Pediatric Community Medicine,Department of Pediatrics, CHEO Member, C.M.E. Committee, University of Ottawa

DR. MONA JABBOURAssociate Professor of Pediatrics, University of OttawaChief, Division of Pediatric Emergency Medicine, CHEO

DR. LOU LAWTONAssociate Professor, Department of Surgery, University of OttawaDivision of Pediatric Orthopedic Surgery, CHEO

DR. JAMES MCCONVILLEDivision of Pediatric Community Medicine, Department of Pediatrics, CHEOMember, C.M.E. Committee, University of Ottawa

DR. ASHA NAIRAssistant Professor, University of OttawaDivision of Developmental Pediatrics, CHEOMember, C.M.E. Committee, University of Ottawa

DR. MARK NORRISAssistant Professor of Pediatrics, University of OttawaRegional Eating Disorders Program and Adolescent Health, CHEO

DR. STEPHEN NOSEWORTHYAssistant Professor, University of OttawaDivision of Pediatric Emergency Medicine, CHEO

DR. ANDREW PIPEProfessor, Department of Family Medicine and Division of Cardiac Surgery,Director, Division of Prevention and Rehabilitation, University of Ottawa Heart Institute

DR. ANITA POZGAYAssistant Professor, University of OttawaDepartment of Emergency Medicine, The Ottawa HospitalDip Sport Med, Ottawa Sport Medicine Centre

DR. SARAH REIDAssistant Professor, University of OttawaDivision of Pediatric Emergency Medicine, CHEOChair, Continuing Medical Education

DR. ANNE ROWAN-LEGGAssistant Professor, University of OttawaDivision of Pediatric Medicine, CHEO

DR. LINDY SAMSONAssociate Professor of Pediatrics, University of OttawaDivision of Pediatric Infectious Diseases, CHEO

DR. DEREK WONGAssistant Professor, University of Ottawa, Division of Cardiology, CHEO

DR. MARC ZUCKERAssistant Professor, University of OttawaDivision of Pediatric Medicine, CHEO

DR. SARAH SHEAAssociate Professor, Department of Pediatrics, Dalhousieand Director of Pediatric Undergraduate Medical Education, Halifax, NS

Faculty

Guest Faculty

Registration FeesPhysicians: Early $400.00 (daily rate $275) Late: (after November 5th) $425.00

Nurses: Early $200.00 (daily rate $150) Late: (after November 5th) $240.00

Residents: $75 (daily rate: $50)

Refunds (less $50.00 service charge) will be made only on cancellations received by Friday, November 5th, 2010.

Accommodation This Course will be held at: The Westin Ottawa

11 Colonel By Drive, Ottawa K1N 9H4

Reservations: 613-560-7000 Fax: 613-234-5396

For special room rates $189 plus tax. (Single/Double) by October 31, 2010.

Mention – “Children’s Hospital of Eastern Ontario” – Pediatric Refresher Course.

Registrants are requested to book directly with the Hotel.

Enquiries:Louise Lafl eur, Coordinator

Offi ce of Continuing Medical Education

Children’s Hospital of Eastern Ontario,

Ottawa, Canada K1H 8L1 Tel.: 613-737-2285 FAX: 613-738-4297

E-mail: lafl [email protected]

THE

ANNUAL PAEDIATRIC REFRESHER COURSEDECEMBER 3 and 4, 2010 ~ The Westin OttawaOttawa, Ontario, Canada35 th

ANNUAL PAEDIATRIC REFRESHER COURSEDECEMBER 3 and 4, 2010 ~ The Westin OttawaOttawa, Ontario, Canada35 th

Course ObjectivesAfter attending this course, participants will be able to:

Identify and manage common and important medical problems in •

children and youth.

Refl ect on practice in light of new developments in the care of •

children and youth, and decide whether a change in practice is

appropriate.

Specifi c objectives for each session will be described by the •

presenter.

Target AudiencePediatricians, Family Physicians, Pediatric and Family Medicine •

Residents, Nurses, Nurse Practitioners, and other Health

Professionals interested in Child Health.

The Royal College of Physicians and Surgeons of Canada, Region 3 Advisory Committee, has provided a continuing education grant in support of our meeting.

Planning CommitteeDr. Sarah Reid, Dr. Mona Jabbour, Dr. Paul Hendry, Dr. Thérèse Hodgson,

Dr. Chuck Hui, Dr. David Huot, Dr. Asha Nair, Dr. Jim McConville

Program of Continuing Medical Education, Children’s Hospital of Eastern Ontario Faculty of Medicine, University of Ottawa

SeminarsPlease number in order of preference. PLEASE MAKE CHOICES IN EACH SESSION5 Seminars to choose from (repeated x1): Session #1 Morning and Session #2 Afternoon

Remember to register early. Seminars are limited and assigned on a fi rst come, fi rst served basis.

Please log onto our web site to view workshop/plenary descriptions www.pediatrics.uottawa.ca, Medical Education

Friday, December 3, 20101100–1200 SEMINARS – Session #1 repeated in Session #2 @ 1400–1500 hrs.___ A TALK BY 2: Know the signs. Act early. Roxane Bélanger

Early identifi cation and intervention of Speech and Language Delays

___ B Pediatric Globetrotters—Pre and Post-Travel Care for Children Dr. Jason Brophy ___ C “Kicking Butts”: Smoking Cessation Strategies for Adolescents Dr. Andrew Pipe and Dr. Mark Norris

___ D Pediatric Sports=Injuries: How are children different? Dr. Anita Pozgay

___ E Who’s in shock here, the patient or the offi ce staff? Dr. Steve Noseworthy and

Offi ce Emergency Preparedness Using HiFi Simulation Dale Dalgleish, RN

**NB: enrollment limited to 10 per session**

Saturday, December 4, 20101130–1230 SEMINARS – Session #1 repeated in Session #2 @ 1330–1430 hrs.___ F Pediatric Dermatology Review Dr. Jennifer Beecker___ G When to Refer to Peds Ortho Dr. Lou Lawton___ H Tackling Childhood Obesity in the Clinical Setting Dr. Stasia Hadjiyannakis___ I ENT Emergencies Dr. Matthew Bromwich ___ J Tales from the Cardiology Clinic Dr. Derek Wong

Mail or Fax to: Ms. Louise Lafl eur,

Coordinator, Continuing Medical Education

Children’s Hospital of Eastern Ontario

401 Smyth Road, OTTAWA, CANADA K1H 8L1

TEL.: 613-737-2285

FAX: 613-738-4297

Page 2: Peldiatric Refresher 2010 Proof 4 - med.uottawa.ca€¦ · The Westin Ottawa has many amenities available: gym, spa services, indoor salt water pool, whirlpool, squash courts, etc

Saturday, December 4, 20100800 Coffee and Croissants – (Foyer Governor General II/III – Level 4 with Exhibitors)

CHAIR Dr. Asha Nair (Governor General II/III – Level 4)

0830 – 0915 2010 News: Update on Pediatric Practice Guidelines Dr. Anne Rowan-Legg

0915 – 1000 Newborn Screening: Where we are and where we are going Dr. Pranesh Chakraborty

1000 – 1100 Immunization Update Dr. Lindy Samson

1100 – 1130 NUTRITION BREAK (Foyer Governor General II/III – Level 4 with Exhibitors)

1130 – 1230 SEMINARS – Session #1 (Small Groups of 25–30 – Interactive Sessions)

A2 Pediatric Dermatology Review Dr. Jennifer Beecker

B2 When to Refer to Peds Ortho Dr. Lou Lawton

C2 Tackling Childhood Obesity in the Clinical Setting Dr. Stasia Hadjiyannakis

D2 ENT Emergencies Dr. Matthew Bromwich

E2 Tales from the Cardiology Clinic Dr. Derek Wong

1230 – 1330 LUNCHEON – Governor General II/III – Level 4

1330 – 1430 SEMINARS – Session #2 (Small Groups of 25–30 – Interactive Sessions)

F2 Pediatric Dermatology Review Dr. Jennifer Beecker

G2 When to Refer to Peds Ortho Dr. Lou Lawton

H2 Tackling Childhood Obesity in the Clinical Setting Dr. Stasia Hadjiyannakis

I2 ENT Emergencies Dr. Matthew Bromwich

J2 Tales from the Cardiology Clinic Dr. Derek Wong

1430 – 1445 NUTRITION BREAK (Foyer Governor General II/III – Level 4 with Exhibitors)

1445 – 1545 Pediatric Dermatology Photo Quiz Dr. Jennifer Beecker

1545 – 1645 Best Articles of the Year Dr. Marc Zucker

Outaouais AttractionsThe Westin Ottawa has many amenities available: gym, spa services, indoor salt water pool, whirlpool, squash courts, etc.

and spectacular views of the Rideau Canal and Byward Market.

Drive, bike or hike through the Gatineau Hills and stop at the Lookouts for picturesque photo opportunities. There are

a wealth of museums, art galleries and historical monuments in the region… Canada Science & Technology Museum,

Canadian Museum of Civilization, Canadian Museum of Nature, Canadian War Museum, Currency Museum of the Bank of

Canada, National Gallery of Canada, Parliament Hill and Dow’s Lake.

Take a leisurely walk, rollerblade, jog or cycle along the Rideau Canal! At your doorstep, you’ll fi nd the Byward Market,

which provides excellent choices for shopping with one-of-a-kind shops and boutiques, many restaurants and cafés,

nightlife and Canada’s oldest continuously operating farmers’ market. If you are looking for a unique spa experience

away from the hotel and Ottawa, visit Le Nordik Spa (a little fl avour of Scandinavia) in picturesque Old Chelsea, Quebec

(~ 30 minutes from Ottawa); or spend some time at The Spa, with 2 locations in Bells Corners, one in a former church and

the other in a restored farmhouse (~20 minutes from Ottawa).

The Westin Ottawa has an indoor walkway to the Rideau Centre Shopping Mall. The National Art Centre, located close

by, and the Casino du Lac-Leamy, located in the Hull Sector of Gatineau (~15 minute drive) provide another source of

entertainment… check their web sites to see listings of music concerts, dance and theatre productions being offered during

your stay.

Friday, December 3, 20100745 REGISTRATION (Foyer Governor General II/III – Level 4)

Coffee and Croissants (Governor General II/III – Level 4 with exhibitors)

CHAIR Dr. Chuck Hui (Governor General II/III – Level 4)

0820 Opening Remarks — Dr. Chuck Hui

0830 – 0930 “When Good Meds Go Bad”— Medication Management Dr. Sarah SheaDilemmas in ADHD and Autistic Disorders

0930 – 1030 The Dope on Drugs: Cannabis Use and Abuse in Adolescents Dr. Mark Norris

1030 – 1100 NUTRITION BREAKFoyer Governor General II/III – Level 4 (with Exhibitors)

1100 – 1200 SEMINARS – Session #1 (Small Groups of 25–30 – Interactive Sessions)

A1 TALK BY 2: Know the signs. Act early. Roxane BélangerEarly Identifi cation and Intervention of Speech and Language Delays

B1 Pediatric Globetrotters—Pre and Post-Travel Care for Children Dr. Jason BrophyC1 “Kicking Butts”: Smoking Cessation Strategies for Adolescents Dr. Andrew Pipe and

Dr. Mark NorrisD1 Pediatric Sports=Injuries: How are children different? Dr. Anita Pozgay E1 Who’s in shock here, the patient or the offi ce staff? Dr. Steve Noseworthy and

Offi ce Emergency Preparedness Using HiFi Simulation Dale Dalgleish, RN

1200 – 1300 LUNCHEON – Governor General II/III – Level 4

1300 – 1400 VICTOR MARCHESSAULT MEMORIAL PRESENTATION Dr. Sarah Shea

(Governor General II/III – Level 4)“If I Were Queen of the World: Refl ections on Needed Change by a Would-be Evidence-Based Despot”

1400 – 1500 SEMINARS — Session #2 (Small Groups of 25–30 – Interactive Sessions)

F1 TALK BY 2: Know the signs. Act early. Roxane BélangerEarly Identifi cation and Intervention of Speech and Language Delays

G1 Pediatric Globetrotters—Pre and Post-Travel Care for Children Dr. Jason BrophyH1 “Kicking Butts”: Smoking Cessation Strategies for Adolescents Dr. Andrew Pipe and

Dr. Mark NorrisI1 Pediatric Sports=Injuries: How are children different? Dr. Anita Pozgay J1 Who’s in shock here, the patient or the offi ce staff? Dr. Steve Noseworthy and

Offi ce Emergency Preparedness Using HiFi Simulation Dale Dalgleish, RN

1500 – 1530 NUTRITION BREAKFoyer Governor General II/III – Level 4 (with Exhibitors)

1530 – 1630 Genetics in Primary Care Pediatrics—What do I need to know? Dr. Judith Allanson

Course Registration

ONLINE REGISTRATION NOW AVAILABLEPlease log onto our web site www.pediatrics.uottawa.ca, Medical Education

35th Annual Paediatric Refresher CourseDecember 3 and 4, 2010The Westin Ottawa, 11 Colonel By Drive, Ottawa, ON K1N 9H4

Remember to include your seminar choices!

Please Print

MD Graduation School _______________________________________________________________________________________ Year _____________

RN/Nurse Practitioner ________________________________________________________________________________________ Year _____________

Name _________________________________________________________________________________________________________________________

Address ______________________________________________________________________________________________________________________

Number Street/Avenue Suite

_____________________________________________________________________________________________________________________

City/Town Province Postal Code

Telephone ( ) ____________________________________ ( ) _________________________________

Residence Business

E-mail address: ________________________________________________________________________________________________________________

Pediatrician Family Physician RN/Nurse Practitioner Resident

Payment

Please make cheque payable to: Continuing Medical Education — CHEO

Handouts: CD or Paper (additional $25 fee)

Registration Fee:

Physicians: $400 (daily rate $275) $425 Late Fee (after November 5th)

Nurses: $200 (daily rate $150) $240 Late Fee (after November 5th)

Residents: $75 (daily rate: $50)

Refunds (less $50 service charge) will be made only on cancellations received by Friday, November 5th, 2010.

VISA MASTERCARD Fee: $ ______________

__________________________________________________ _____________________________________________________

Card Number Cardholder

__________________________________________________ _____________________________________________________

Date of Expiration Signature

No scents makes good sense…For the comfort and health of our Pediatric Refresher Course attendees and presenters,

please refrain from wearing scented products. Thank you!