16th Annual Interdisciplinary Conference on Supportive Care, Hospice and Palliative Medicine September 7–8, 2012 FEATURING: J. Andrew Billings, MD Former Director of the Massachusetts General Hospital Palliative Care Service, and Co-Director, Harvard Medical School Center for Palliative Care.The following Review Course will be offered prior to the Conference8th Annual Intensive Physician Board Review Course in Hospice and Palliative Medicine September 4–6, 2012 NEW: Webinar sessions for Physicians Board Review Course The University of Texas MD Anderson Cancer Center Main Building, Hickey Auditorium, Floor 11 1515 Holcombe Boulevard, Houston, Texas
16th Annual Interdisciplinary Conference onSupportive Care, Hospice and Palliative MedicineGoal EvaluationCaring for the cancer patient in the advanced stage of illness A course evaluation form will provide participants with the opportunity to comment onis particularly challenging to the healthcare team. It requires the value of the program content to their practice decisions, performance improvementattending to the many dimensions of care including medical, activities, or possible impact on patient health status. Participants will also have thepsychosocial, ethical and spiritual needs. This is the sixteenth opportunity to comment on any perceived commercial bias in the presentations as wellyear of the conference. It continues to be important to provide as to identify future educational topics.educational updates in the field of palliative and hospicecare – which includes pain, other symptom management and Accreditation/Credit DesignationEnd-of-Life issues. We believe this conference will provide The University of Texas MD Anderson Cancer Center is accredited by the Accreditationparticipants with practical information with which to better Council for Continuing Medical Education to provide continuing medical education forcare for patients with advanced cancer and other illnesses physicians.and their families. The University of Texas MD Anderson Cancer Center designates this live activityEducational Objectives for a maximum of 15.25 AMA PRA Category 1 Credits™. Physicians should claim onlyAfter attending the conference, participants should be able to the credit commensurate with the extent of their participation in the activity.• identify moral and ethical dilemmas facing clinicians who provide End-of-Life care (knowledge, competence); Ethics• practice state-of-the-art pain and symptom management for This course has been designated by The University of Texas MD Anderson patients with advanced disease (knowledge, competence, Cancer Center for 15.25 AMA PRA Category 1 Credits™ in medical ethics and/or performance, patient outcomes); professional responsibility.• demonstrate effective communication with patients in the advanced stages of cancer or debilitating disease and Nursing provide quality End-of-Life care (knowledge, competence, The University of Texas MD Anderson Cancer Center is an approved provider of performance); continuing nursing education by the Texas Nurses Association, an accredited approver• exhibit heightened awareness of the medical, legal and by the American Nurses Credentialing Center’s Commission on Accreditation. spiritual issues facing patients and families involved in the care of advanced disease (knowledge, competence). Nursing Continuing Education Contact Hours will be awarded.Target Audience CME Certificates and Attendance Verification CertificatesThis program should be of interest to palliative care or hospice Certificates awarding AMA PRA Category 1 Credits™ or certificates documentingphysicians, oncologists, internal medicine physicians, family attendance will be distributed to participants when an individual departs thepractice physicians, psychiatrists, and/or anesthesiologists. conference. To obtain a CME certificate, physicians must submit a completedOther professionals including: hospice, nursing, psychology, evaluation questionnaire and a CME Verification Form. Upon receipt, a record ofchaplaincy, ethics, and/or sociology. attendance (certificate) will be provided on-site to other health care professionals for requesting credits in accordance with state nursing boards, specialty societies,Educational Methods or other professional associations.Lectures • Workshop Sessions • Case Studies Conference Organizing Committee Sriram Yennu, MD (Chair) Eduardo Bruera, MD Ana Leech, MD Maureen Valenza (Program Coordinator) Debra Castro, RN Linh Nguyen, MD Eric Gagneaux (Logistics Manager) James Cavelier, Jr., RN Lindsey Pimentel, RN Inez Rodriguez (Administrative Support) (Nurse Planner) Akhila Reddy, MD Maxine De La Cruz, MD Eden Mae Rodriguez, PharmD Jeanette Ferrer, MD Joseph Roosth, MD Sandra Gomez, MD Natalie Schuren, RN Holly Holmes, MD Kay Swint, RN Tricia Kinnard, RN Steven Thorney, MDiv
16th Annual Interdisciplinary Conference on Supportive Care, Hospice and Palliative MedicineSeptember 7–8, 2012Friday, September 7, 2012 2. Motivational Interviewing and the Trans- theoretical Model of Behavioral Change as 3. Management of Difficult Behaviors Associated with Borderline Personality Resources for Palliative Care Providers Disorder at the End-of-Life7:15 am On-Site Registration / Continental Breakfast Warren Holleman, PhD Rachel Havyer, MD; Molly Feely, MD 3. Antimicrobial Stewardship: 4. One Step Closer to Heaven: Envisioning7:45 Welcome the Afterlife in the Artworks of Palliative Sriram Yennu, MD Why and How in a Cancer Hospital and the Advanced Cancer Patient Care Patients8:00 Palliative Care and Heart Failure: Kenneth Rolston, MD; Frank Tverdek, MD; Marcia Brennan, PhD The Forgotten Majority Roy Chemaly, MD 10:00 Morning Break Deborah Meyers, MD 4. GI Interventions in Palliative Care9:00 Introduction of Featured Speaker Alexander Dekovich, MD 10:15 PLENARY SESSION Eduardo Bruera, MD 5. Medication Transitioning from Hospital Prognosis of Cancer Pain9:15 Featured Speaker to Hospice Eduardo Bruera, MD Clinical Delivery of Palliative Care: Maxine De La Cruz, MD; T. Hanh Trinh, MD 11:15 WORKSHOPS: Changing Standards 3:30 Afternoon Break 1. Self-Care for Busy Professionals J. Andrew Billings, MD Warren Holleman, PhD10:15 Morning Break 3:45 RAPID FIRE SESSIONS: 2. Nuts and Bolts of the Functioning of a 1. Understanding Healthcare Professional Supportive Care Outpatient Clinic and10:30 WORKSHOPS: Views of Family Presence During Pediatric Palliative Medicine Program 1. Interventional Pain Techniques for the Resuscitation: Implications for Family- Rony Dev, DO; Lindsey Pimentel, RN Management of Refractory Cancer Pain in Centered Care Advanced Cancer Patients 3. Management of Delirium in Geriatric Barbara Jones, PhD Larry Driver, MD Patients 2. Symptom Profiles in Children with Advanced Maxine De La Cruz, MD 2. Finding the Right Words: The use of Allow Cancer Attending an Outpatient Oncology 4. Compassionate Care in Parkinson’s Natural Death (AND) and Do Not Resusci- Clinic: Child and Family Caregiver Ratings Disease tate (DNR) in Pediatric Palliative Care Donna Zhukovsky, MD Anita Madan, MD Barbara Jones, PhD 3. Do Printed Symptom Reports Influence Clinical & Management? A Longitudinal Controlled Trial 12:15pm Lunch (provided) Talk to Me: Parent Perspectives of of Patient-Reported Outcomes (PROs) in Family-Provider Communication at 1:00 WORKSHOPS: Patients Receiving Chemotherapy 1. Pediatric Palliative Care from the End-of-Life Belinda Luk, MPH Donna Zhukovsky, MD Perspective of Bereaved Parents 4. Patient-Physician Communication About Rhonda Robert, MD 3. Sub Q Medications: Code Status Preferences: A Randomized Review of Alternative Routes 2. What Do We Do Now? Child Life Helping Controlled Trial Families Cope with Grief/Building a Linh Nguyen, MD; Eden Mae Rodriguez, PharmD Wadih Rhondali, MD Legacy 4. Ethnic Variations in End-of Life 5. The Effects of Light Therapy on RI Xerostomia Sheila Brown, BA; Thuy Trinh, MS; Treatment Preference: Research and Shelly Patel, DDS Nicole Gandolfo, MA Practice Implications 6. Discussion of Presentations Isabel Torres, DrPH 3. Dexamethasone: Symptom Distress Donna Zhukovsky, MD Sriram Yennu, MD11:30 WORKSHOPS: 5:30 pm Adjourn 4. Emergency Room: Role of Palliative Care 1. Lessons Learned: Removing Ventilatory Ahmed Elsayem, MD Support From Hospice Patients at Home 5. Challenging Cases in Pain Management: Kenneth Unger, MD 2. Cultural Differences in Delivering Saturday, September 8, 2012 A Focus on Methadone and Fentanyl Akhila Reddy, MD; Eden Mae Rodriguez, PharmD Palliative Care: The Example Italy Deborah Bolognesi, MA; Guido Biasco, MD 7:30 am On-Site Registration / Continental Breakfast 2:00 RAPID FIRE: & 8:00 WORKSHOPS: 1. Association of Child & Proxy Reports of Partnering with Rwanda to Cultivate 1. Association Between Body Image Dissatis- Symptoms Experienced by English and the Peace-Building Opportunities of faction and Weight Loss Among Advanced Spanish Speaking Children Treated in a Hospice & Palliative Care Cancer Patients and their Caregivers Pediatric Oncology Clinic David Slack, MD; Angela Lee, RN; Wadih Rhondali, MD Donna Zhukovsky, MD Grace Mukankuranga, RN 2. Self-reported Constipation in Patient 2. Opioid Rotation in an Outpatient Palliative 3. Malignant Bowel Obstruction Care Center and Case Scenarios of Morphine, with Advanced Cancer Marieberta Vidal, MD Oxycodone and Hydromorphine Wadih Rhondali, MD & Akhila Reddy, MD; Eden Mae Rodriguez, PharmD 3. The Impact of Postoperative Complica- Venting Gastrostomy for Supportive tions on Outcomes for Patients with Management of Bowel Obstruction in 3. Quality Improvement (QI) in Palliative Care Linh Nguyen, MD Cancer Treated with Palliative Surgery Advanced Recurrent Ovarian Malignancy Thomas Aloia, MD; Amanda Cooper, MD Timothy DeEulis, MD 4. Having Difficult Conversations in the Palliative and Hospice Settings 4. Pediatric Palliative Care Primer for 4. Palliative Treatment of Malignant Suresh Reddy, MD; Meagan Davis, LMSW Non-Pediatric Providers Central Airway Involvement: Regina Okhuysen-Cawley, MD; The Sooner, the Better 9:00 WORKSHOPS: Shih-Ning Liaw, MD Roberto Casal, MD 1. Supportive and Palliative Oncology Literature: 5. Medical Oncologist Perception of12:30 pm Lunch (provided) Quantity, Scope, Design, Challenges and Palliative Care Programs and the Opportunities Impact of Name Change to Supportive1:15 PLENARY SESSION David Hui, MD Care on Communication with Patients: The Family Meeting in End-of-Life Care 2. The Effects of a Comprehensive Hospital A Qualitative Study J. Andrew Billings, MD Bereavement Care Program on Grieving Wadih Rhondali, MD Patients and Families 6. Discussion of Presentations2:15 WORKSHOPS: Marci Pounders, BCC David Hui, MD 1. Keeping it G-Rated: Talking with Children & about a Parent’s Expected Death Effective Family Conference Communication 3:45 pm Conference Adjourns Martha Aschenbrenner, MSW Luke Coulson, LMSW
8th Annual Intensive Physician Board Review Course in Board Review Hospice and Palliative Medicine Organizing Committee Sriram Yennu, MD (Chair) September 4–6, 2012 Maureen Valenza (Program Coordinator) Eric Gagneaux (Logistics Manager) Eduardo Bruera, MD Shalini Dalal, MDGoal Educational Methods Egidio Del Fabbro, MDCaring for the cancer patient in the advanced stages of disease is Lectures • Case Studies • Meet the Professor Sessions Rony Dev, DOparticularly challenging to the healthcare team. It requires attend- Marvin Delgado-Guay, MDing to the many dimensions of care including medical, psychosocial, Evaluation Maxine De La Cruz, MDethical, and spiritual needs. In the eighth year, the Intensive Board A course evaluation form will provide participants with the David Hui, MDReview Course in Hospice and Palliative Medicine continues to offer opportunity to comment on the value of the program content to their Akhila Reddy, MDparticipants educational updates and literature review to help them practice decisions, performance improvement activities, or possiblesuccessfully take the certification examination. impact on patient health status. Participants will also have the Suresh Reddy, MD opportunity to comment on any perceived commercial bias in the Paul Walker, MDEducational Objectives presentations as well as to identify future educational topics. Donna Zhukovsky, MDAfter attending the conference, participants should be able to• identify and interpret the moral and ethical dilemmas Accreditation/Credit Designation encountered at the End-of-Life (knowledge, competence); The University of Texas MD Anderson Cancer Center is accredited by the Accreditation Council• provide optimal End-of-Life care to include state-of-the-art pain for Continuing Medical Education to provide continuing medical education for physicians. and symptom management for patients with advanced disease The University of Texas MD Anderson Cancer Center designates this live activity for (knowledge, competence, performance, patient outcomes); a maximum of 27.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit• apply effective communication techniques with patients in the commensurate with the extent of their participation in the activity. advanced stages of cancer or debilitating disease and provide End-of-Life care (knowledge, competence, performance); Ethics• effectively discuss the medical, legal, and spiritual issues facing This course has been designated by The University of Texas MD Anderson Cancer Center for patients with advanced disease (knowledge, competence). 27.00 AMA PRA Category 1 Credits™ in medical ethics and/or professional responsibility.Target Audience CME Certificates and Attendance Verification CertificatesThis program will be of interest to hospice and palliative care Certificates awarding AMA PRA Category 1 Credits™ or certificates documenting attendance will bephysicians, medical oncologists, family practice physicians, distributed to participants when an individual departs the conference. To obtain a CME certificate, physiciansanesthesiologists, psychiatrists, fellows, advance practice must submit a completed evaluation questionnaire and a CME Verification Form. Upon receipt, a record ofnurses, and other health care professionals involved in hospice attendance (certificate) will be provided on-site to other health care professionals for requesting credits inand palliative care. accordance with state nursing boards, specialty societies, or other professional associations. Tuesday, September 4, 2012 Wednesday, September 5, 2012 Thursday, September 6, 2012 7:15 am On-Site Registration / Continental Breakfast 7:30 am Continental Breakfast 7:30 am Continental Breakfast 8:00 Introduction and General Overview of 8:00 Opioid Titration and Rotation 8:00 Psychosocial and Spiritual Issues Course: How to Take the Exam Suresh Reddy, MD Marvin Delgado-Guay, MD Sriram Yennu, MD 9:00 Management of Anxiety/Depression 9:00 Delirium, Palliative Sedation, and at the End-of-Life 8:15 Pediatric Palliative Care Opioid Induced Neurotoxicity Donna Zhukovsky, MD Marvin Delgado-Guay, MD Eduardo Bruera, MD 9:45 Break 9:45 Break 10:00 Break 9:55 Common Pharmacological Interactions 10:00 Palliative Care in the Last Week of Life: 10:15 Fatigue and Sleep Disturbance in Palliative Care Signs and Symptoms in the Last 24 Hours/ Sriram Yennu, MD Holly Holmes, MD Hydration/Oral Secretions/Communicating about Impending Death/Management of 10:30 Disease Specific Palliative Care I the Death Rattle/Delirium 11:15 Adjuvant Intervention and Integrative Neurological, AIDS Eduardo Bruera, MD Approaches in Pain Management Maxine De La Cruz, MD Suresh Reddy, MD 11:00 Dyspnea/Cough 11:30 Lunch: Meet the Professor David Hui, MD 12:15 pm Lunch: Q & A Live and Webinar Meet the Professor Q & A - Live and Webinar Suresh Reddy, MD 11:45 Lunch: Meet the Professor Session Eduardo Bruera, MD Case Presentation/Discussion 12:45 pm Medicare Hospice Benefit Donna Zhukovsky, MD 1:30 Cachexia/ Nausea/Vomiting/Bowel Linda Tavel, MD Obstruction/Constipation 12:45 pm Chemotherapy, Targeted Therapy Eduardo Bruera, MD 1:45 Disease Specific Palliative Care II and Radiation: Principles and Common Cardiac, Pulmonary, and Renal Adverse Effects 2:30 Interdisciplinary Team Work Dynamics – Sandra Gomez, MD David Hui, MD Conflict Resolution 2:45 Wound Care/Pressure Ulcers/ Suresh Reddy, MD Pruritis/Xerstomia 1:45 Pain: Assessment and Principles Eduardo Bruera, MD Linh Nguyen, MD 3:00 Break 3:15 Break 3:00 Break 3:15 Prognostication David Hui, MD 3:30 Ethical and Legal Decision Making 3:15 Geriatric Palliative Care Larry Driver, MD Marvin Delgado-Guay, MD 4:30 Palliative Care Emergencies 4:30 Conclusion and Course Overview 4:15 Grief & Bereavement Maxine De La Cruz, MD Sriram Yennu, MD Rony Dev, DO 5:30 pm Adjourn 4:45 pm Adjourn 5:15 pm Adjourn
CONFERENCE SPEAKERS MD Anderson Faculty Sriram Yennu, MD (Chair) Maxine De La Cruz, MD Suresh Reddy, MD Martha Aschenbrenner, MSW Alexander Dekovich, MD Wadih Rhondali, MD Thomas Aloia, MD Rony Dev, DO Eden Mae Rodriguez, PharmD Marcia Brennan, PhD Larry Driver, MD Rhonda Robert, MD Sheila Brown, BA Ahmed Elsayem, MD Kenneth Rolston, MD Eduardo Bruera, MD Nicole Gandolfo, MA Thuy Trinh, MS Regina Okhuysen-Cawley, MD Warren Holleman, PhD Frank Tverdek, MD Roy Chemaly, MD David Hui, MD Marieberta Vidal, MD Amanda Cooper, MD Lindsey Pimentel, RN Donna Zhukovsky, MD Luke Coulson, LMSW Akhila Reddy, MD Guest Faculty Guido Biasco, MD Barbara Jones, PhD Linh Nguyen, MD University of Bologna The University of The University of Texas Bologna, Italy Texas – Austin Health Science Center Austin, Texas Houston, Texas J. Andrew Billings, MD Massachusetts General Angela Lee, RN Shelly Patel, DDS Hospital Hospice Without Borders The University of Texas Cambridge, Massachusetts University Place, Health Science Center Washington School of Dentistry Deborah Bolognesi, MA Academy of Sciences Grace Mukankuranga, RN Houston, Texas of Palliative Medicine Rwanda Palliative Care Marci Pounders, BCC Bologna, Italy Center (RHPCC) Baylor Cancer Hospital Rwanda, Africa Houston, Texas Roberto Casal, MD Baylor College of Medicine Shih-Ning Liaw, MD David Slack, MD Houston, Texas The University of Texas Hospice Without Borders Meagan Davis, LMSW Medical School Olympia, Washington Solari Hospice Care Houston, Texas Isabel Torres, DrPH Spring, Texas Belinda Luk, MPH University of Houston Timothy DeEulis, MD Oregon Health & Houston, Texas St. Mary’s Medical Center Science University Portland, Oregon T. Hanh Trinh, MD Huntington, West Virginia Houston Hospice Molly Feely, MD Anita Madan, MD Houston, Texas Mayo Clinic The University of Texas Health Science Center Kenneth Unger, MD Rochester, Minnesota VITAS Innovative Houston, Texas Rachel Havyer, MD Hospice Care Mayo Clinic Deborah Meyers, MD Houston, Texas Rochester, Minnesota The University of Texas Health Science Center Houston, TexasBOARD REVIEW SPEAKERS MD Anderson Faculty Guest Faculty Sriram Yennu, MD (Chair) Sandra Gomez, MD Eduardo Bruera, MD SMC Palliative Care Services, P.A. Maxine De La Cruz, MD The Woodlands, Texas Marvin Delgado-Guay, MD Linh Nguyen, MD Rony Dev, DO UT Health Science Center Larry Driver, MD Houston, Texas Holly Holmes, MD Linda Tavel, MD David Hui, MD Odyssey Healthcare of Houston Suresh Reddy, MD Houston, Texas Donna Zhukovsky, MD
Registration Information Special Assistance Contact the Department of CME/Conference8th Annual Intensive Physician Board Review Course – September 4-6, 2012 Management at 713-792-2223 or toll free at• On-site registration and check-in opens at 7:15 am on Tuesday, September 4, 2012, 866-849-5866 if you have any special dietary in the Hickey Auditorium Foyer on Floor 11 of the R. Lee Clark Clinic, MD Anderson, or ADA accommodation needs. 1515 Holcombe Boulevard, Houston, Texas.• The opening session will begin at 8:00 am on Tuesday, September 4, 2012, in Hickey Auditorium and Anderson Conference Hall, and will adjourn at 4:45 pm on Accommodations Thursday, September 6, 2012. The conference is providing a block of rooms at the Houston Marriott at the Texas MedicalThe Physician Board Review Course registration fee includes materials, continental breakfasts, Center Hotel, 6580 Fannin Street, Houston,lunches, and breaks; however, it DOES NOT include registration to the 16th Annual Conference. Texas 77030. Hotel Phone 713-796-0080. When making hotel reservations be sure to useWebinar Sessions the Group Rate code of PLVPLVA to obtain the• Live Webinar Sessions of Board Review Course $139 room rate for single/double occupancy.• Post Webinar Sessions. Recorded Workshop Sessions and Slides Available by Monday, Please add 17% Texas State and local taxes. September 17, 2012. You may also visit www.hotels.com for other (No CME Granted for Webinar Sessions. Recording of Webinar Sessions Not Possible.) hotels within the Texas Medical Center area of Houston, Texas.16th Annual Interdisciplinary Conference on Supportive Care, Air Travel – United AirlinesHospice and Palliative Medicine – September 7-8, 2012 The University of Texas MD Anderson Cancer• On-site registration and check-in opens at 7:15 am on Friday, September 7, 2012, in the Center has a program with United Airlines for Hickey Auditorium Foyer on Floor 11 of the R. Lee Clark Clinic, MD Anderson, 1515 Holcombe discounted air travel. For discounts, call your travel Boulevard, Houston, Texas. professional or United’s Meeting Works toll free• The opening session of the conference will begin at 7:45 am on Friday, September 7, 2012, at 800-468-7022. Outside of the United States, in Hickey Auditorium, and the conference will adjourn at 3:45 pm on Saturday, please call your local United Airlines Reservation September 8, 2012. Office. The offer code is Z Code: ZM6M and Agreement Code: 488954.The Conference registration fee includes the tuition, materials, continental breakfasts, lunches,and breaks; however, it DOES NOT include registration to the Physician Board Review Course. Lower fares may be available on the internet or through your travel agency.The Deadline for Advance Registration is August 17, 2012There are three ways to register:• Mail to Department of CME/Conference Management, Unit 1381, The University of Texas Ground Transportation MD Anderson Cancer Center, PO Box 301439, Houston, TX 77230-1439 (prices are subject to change)• Fax to 713-794-1724 • Houston is served by two airports, George• On-line at www.mdanderson.org/conferences Bush Intercontinental (IAH) and William P.We accept the following forms of payment: Hobby (HOU).• Check (payable to The University of Texas MD Anderson Cancer Center through • Taxicabs are available at an estimated cost of U.S. banks only) $30-60, to or from both airports.• Money order • Super Shuttle operates a shuttle bus from• Credit cards (MasterCard, VISA, and American Express) both airports at an estimated cost of• Cash (on-site registration only) $24-$27 one-way and $48-$54 round-trip.A receipt and confirmation letter will be sent to you within ten working days of For more information, call 713-523-8888receipt of your registration. or toll-free at 800-258-3826 or on-line at www.supershuttle.com.Refund/Cancellation PolicyThe registration fee, minus a $50 administration-handling fee, is refundable if a written The University of Texas MD Anderson Cancer Center has implemented a process whereby everyone who is in a position to control the contentrequest is received on or before August 17, 2012. No refunds will be granted after that date. of an educational activity must disclose all relevant financialThe request for a registration refund must include the tax identification number of the relationships with any commercial interest that could potentiallycompany or institution if registration was paid by a company or institution check. For affect the information presented. MD Anderson also requires that alladditional information, contact CME/Conference Management at 713-792-2223 or toll free faculty disclose any unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical deviceat 866-849-5866 or via e-mail: firstname.lastname@example.org. products. Specific disclosure will be made to the participants prior to the educational activity.The Department of CME/Conference Management reserves the right to cancel activities prior tothe scheduled date, if low enrollment or other circumstances make it necessary. Each registrant Agendas are subject to change because we are always striving to improve the quality of your educational experience. MD Anderson maywill be notified by mail, e-mail, or at the phone or fax numbers given on the registration form. substitute faculty with comparable expertise on rare occasions neces- sitated by illness, scheduling conflicts, and so forth.In case of activity cancellation, the liability of the Department of CME/Conference Managementis limited to the registration fee. CME/Conference Management will refund the full registration Photographing, audio taping and videotaping are prohibited.fee. The Department of CME/Conference Management reserves the right to limit the number Please let us know what specific topics, issues or questions youof participants in a program and is not responsible for any expenses incurred by an individual wish to see addressed or emphasized in this activity. Call or e-mailwhose registration is not confirmed and for whom space is not available. CME/Conference Management. All responses will be forwarded to the Program Chairs for consideration.
CONFERENCE REGISTRATION0594 16th Annual Interdisciplinary Conference on Supportive Care, Make check or money order payable to: The University of Texas MD Anderson Cancer Center The University of Texas MD Anderson Cancer Center, PO Box 301439, Houston, TX 77230-1439 Hospice and Palliative Medicine – September 7–8, 20120593 8th Annual Intensive Physician Board Review Course in Hospice and Palliative Medicine – September 4–6, 2012 Last Name First MI Highest Degree Department of CME/Conference Management – Unit 1381 Palliative Care Conference & Board Review Department (include box no.) Specialty THIS IS NOT A SELF-MAILER - ADDRESS TO: Institution Physician oYes oNo or fax to 713-794-1724 Street City State/Foreign Country/Zip or Mail Code Daytime Phone (with area code) Cell Phone (with area code) Fax (with area code) E-mail Address Emergency Contact Phone (with area code) Charge the following: oVISA oMasterCard oAmerican Express Credit Card Holder Name (First/Last) Credit Card Holder Billing Address & ZIP Code Credit Card Number or MD Anderson Interdepartmental Transfer (IDT) No. Expiration Date Authorized Signature REQUIRED for credit card or IDT MD Anderson Employee ID No. (REQUIRED) IDT Approver Name (First/Last) please print IDT Approver E-mail 0594 16th Annual Interdisciplinary 0593 8th Annual Intensive Physician Conference on Supportive Care, Board Review Course Hospice and Palliative Medicine September 4–6, 2012 September 7–8, 2012 Physician/Scientist (MD, PhD, includes Resident, Fellow, etc.) Physician/Scientist (MD, PhD) 1 Postmarked by 8/17/2012............... $899 1 Postmarked by 8/17/2012...............$350 1 Postmarked after 8/17/2012...........$400 You must register separately if you wish to attend the Palliative Care Conference. Healthcare Professional (Nurse, Hospice, Clergy, Ethicist, Social Worker, PT, PA, etc.) Board Review Course registrationR E G I S T R AT I O N F E E S 1 Postmarked by 8/17/2012...............$250 DOES NOT include the Conference. 1 Postmarked after 8/17/2012...........$300 Student/Trainee (Fellow, Resident) 1 Postmarked by 8/17/2012...............$100 1 Postmarked after 8/17/2012...........$150 0607 Webinar Sessions MD Anderson - Physician/Scientist (MD, PhD) 1 Postmarked by 8/17/2012...............$200 Live Presentation - 1 Postmarked after 8/17/2012...........$250 Board Review Course..................... $649 (Broadcast simultaneously with the live activity. MD Anderson - Healthcare Professional NO conference materials will be provided for this (Nurse, Hospice, Clergy, Ethicist, Social Worker, PT, PA, etc.) webinar session.) 1 Postmarked by 8/17/2012...............$150 1 Postmarked after 8/17/2012...........$200 Post Board Review Course........... $349 (Recorded sessions and slide presentations will be available by Monday, September 17, 2012. Board Review Attendees - Special Conference Rate - No CME Granted for Webinar Sessions (Special Conference Rate applies only to attendees registered - Recording of Webinar Sessions Not Possible for the 8th Annual Intensive Board Review Course) Physician/Scientist (MD, PhD, includes Resident, Fellow, etc.) 1 Postmarked by 8/17/2012...............$150