2nd Annual Winter Conference on                 WOMEN’S                  HEALTH    Including topics on: Infertility, Uteri...
CONFERENCE DESCRIPTION                                                                  CONTINUING EDUCATION CREDITOur 2 n...
CONFERENCE FACULTY                                  CONFERENCE SCHEDULEPeng T. Fan, MD, FACP                              ...
CONFERENCE REGISTRATION INFORMATION                                                                                     TE...
CONFERENCE LOCATION     This exciting conference will be held at the beautiful Westin Riverfront                    The We...
CONFERENCE & LODGING REGISTRATION FORM                                                                                    ...
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2nd Annual Winter Conference on Women's Health

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2nd Annual Winter Conference on Women's Health

  1. 1. 2nd Annual Winter Conference on WOMEN’S HEALTH Including topics on: Infertility, Uterine Fibroids, PCOS, Orthopedics, Social Media & Your Practice, Herb & Drug Interactions, and much more... Westin Riverfront Resort & Spa BEAVER CREEK, COLORADO February 26 – March 2, 2013 SPONSORED BY “Great combination of education and relaxation. I’ll take some new ideas back to my practice to improve my patients’ healthcare.” – Lynnette Karth, MD “Symposia Medicus puts on excellent conferences with adequate time 35 to enjoy family and environment. The group receptions are also excellent. I certainly will attend another conference.” – Brenda Ames, NP “In addition to the clinically-relevant topics, outstanding lecturers, and exotic locations, Symposia Medicus is one of only a very few continuing SINCE 1978 education companies that provide both physician and nursing credits.” A Non-Profit Corporation for – Thaddeus Stephen Wojick, MDContinuing Medical & Nursing Education for this conference or view other educational conferences at Register On-Line... w w w. s y m p o s i a m e d i c u s . o r g
  2. 2. CONFERENCE DESCRIPTION CONTINUING EDUCATION CREDITOur 2 nd Annual Winter Conference on Women’s Health is designed to provide Physiciansthe most current clinical information in women’s health to obstetricians, Symposia Medicus designates this live activity for a maximum of 16 AMA PRAgynecologists, family physicians, internists, nurse midwives, nurse practitioners, Category 1 Credits™. Physicians should claim only the credit commensuratephysician assistants, nurses, and all other healthcare professionals who care for with the extent of their participation in the activity.women. The primary goal of this conference is to increase the knowledge andenhance competence of attendees. Emphasis will be placed on practical Application has been made with the American College of Obstetricians &application of the evidence-based topics presented. Gynecologists (ACOG) for cognates, Formal Learning.Topics for this year’s conference have been selected based on professional Application for CME credit has been filed with the American Academy of Familypractice gaps identified that resulted from extensive target audience needs Physicians. Determination of credit is pending.assessment data. The needs assessment data were derived from a variety ofsources including evaluations and outcomes data from past participants; clinical Certified Nurse Midwives/Physician Assistantsexpert input; Symposia Medicus’ online survey; and other medical and nursing The American College of Nurse Midwives accepts Category 1 CME approvaldata. from organizations accredited by the ACCME.Conference format will include didactic lectures, case studies, and question and The American Academy of Physician Assistants accepts Category 1 CMEanswer sessions. approval from organizations accredited by the ACCME.An outstanding faculty has been assembled for this conference. Each member Nurse Practitioners/Nurseswas selected based on individual area of expertise and ability to communicate The ANCC contact hours awarded for completion of this conference are 16.current, evidence-based and practical information to participants. Provider is also approved by the California Board of Registered Nursing,You are sure to enjoy our 2 nd Annual Winter Conference on Women’s Health Provider #CEP2335, for 19.2 contact hours.while sharing ideas and experiences with colleagues from across the country inthe beautiful setting of Beaver Creek. Pharmacology Credit for Prescriptive Authority A maximum of 2 hours in pharmacology credit for prescriptive authority may be earned by attending this educational conference. Sessions awardingCONFERENCE OBJECTIVES pharmacology credit for prescriptive authority are denoted with an Rx in the schedule.After participating in this conference, you should have an increased knowledgeof, and enhanced competence to.… EDUCATIONAL RESOURCES• Diagnose and manage polycystic ovarian syndrome Each registrant will receive an extensive conference syllabus that includes• Cite current treatment options for uterine fibroids materials on each topic presented. The full color syllabus will be available for download approximately two weeks prior to the conference (you’ll receive• Distinguish pharmacokinetic (PK) versus pharmacodynamic (PD) interactions an email with instructions). If you wish to receive a paper syllabus (black and important in supplement-drug interactions white type & photos only), please check the box on the registration form in this brochure.• Evaluate and treat shoulder and knee injuries in the female patient If you bring your laptop/tablet to the conference, be aware that there are no• Recognize symptoms of early rheumatoid arthritis in women and create a electrical outlets at the conference tables. Make sure your laptop/tablet is management plan appropriate to each patient fully charged each day. If you are unable to attend this conference, extra copies of this syllabus (eitherACCREDITATION paper or digital copy) will be available one week after the conference. The cost is $60 for a paper syllabus and $25 for the digital copy. To place your order,This educational activity was planned and produced in accordance with the please email publications@symposiamedicus.org.ACCME and ANCC Essentials and Standards relating to continuing medical andnursing education. WINTER ACTIVITIES/SKI LIFT TICKET DISCOUNTS/Symposia Medicus is accredited by the Accreditation Council for Continuing GROUND TRANSPORTATIONMedical Education (ACCME) to provide continuing medical education forphysicians. Winter activities are available for participants and their guests throughout the conference breaks, and discounts will be offered on ski lift tickets, skiSymposia Medicus is accredited as a provider of continuing nursing education school, and ski rental equipment. Additional information regarding theseby the American Nurses Credentialing Center’s Commission on Accreditation. tickets and discounts, as well as ground transportation, will be sent to registrants.Each participant should only claim credit commensurate with the extent of theirparticipation in the activity.Certificates of credit will be given to participants on-site at the conclusion of theconference.Page 2 Conference Brochure #1249, 2nd Annual Winter Conference on Women’s Health Symposia Medicus 35 Since 1978
  3. 3. CONFERENCE FACULTY CONFERENCE SCHEDULEPeng T. Fan, MD, FACP Tuesday, February 26 Friday, March 1Clinical Professor of Medicine 5:30- Registration & Check-in 4:00pm Arthritis in Women:Division of Rheumatology 7:00pm during Group Reception Treatment OptionsDavid Geffen School of Medicine at UCLA (Rx = 25 minutes)Los Angeles, California Peng Fan, MD Wednesday, February 27 4:45 Endometriosis & Pelvic PainC. David Geier, Jr., MD 6:30am Continued Registration & Check-in (Rx = 15 minutes)Director, MUSC Sports Medicine Continental Breakfast William Schlaff, MDAssistant Professor of Orthopaedic SurgeryMedical University of South Carolina 7:00 Conference Introduction 5:45 Herb & Drug Interactions:Charleston, South Carolina Jay Goldberg, MD, MSCP Separating Fact From Fiction (Rx = 20 minutes) 7:15 Polycystic Ovarian Syndrome: Candy Tsourounis, PharmDJay Goldberg, MD, MSCP Characteristics & ControversiesConference Co-Chairman (Rx = 10 minutes) 6:30 Questions & AnswersAssociate Professor William Schlaff, MD Group DiscussionDirector, Division of General Faculty Panel & Audience 8:15 HPV & Pap Smear: Current GuidelinesObstetrics and Gynecology (Rx = 10 minutes) 7:15 Adjourn Afternoon SessionDirector, Jefferson Fibroid Center Jay Goldberg, MD, MSCPJefferson Medical CollegePhiladelphia, Pennsylvania 9:00 Physical Examination of the Knee, Saturday, March 2 Ankle & Shoulder C. David Geier, Jr., MD 6:30am Continental BreakfastWilliam D. Schlaff, MDConference Co-Chairman 9:45 Questions & Answers 7:00 Diagnosis & Treatment of InfertilityProfessor and Chairman Group Discussion (Rx = 15 minutes)Department of Obstetrics and Gynecology Faculty Panel & Audience William Schlaff, MDJefferson Medical College 10:30 Adjourn Morning Session 7:45 Fibromyalgia: Diagnosis & TreatmentPhiladelphia, Pennsylvania (Rx = 15 minutes) Mid-Day Break: 10:30am-4:00pm Peng Fan, MDCandy Tsourounis, PharmDProfessor of Clinical Pharmacy 4:00pm Management of Osteoporosis 2013 8:30 Weight Loss, Dietary Supplements &Medication Outcomes Center Peng Fan, MD the Pursuit of Happiness Candy Tsourounis, PharmDDirector, Drug Information 4:45 Update & Treatment Options forAnalysis Service Uterine Fibroids (Rx = 10 minutes) 9:15 Questions & AnswersUCSF School of Pharmacy Jay Goldberg, MD, MSCP Group DiscussionSan Francisco, California Faculty Panel & Audience 5:45 Stress Fractures in the Female Athlete C. David Geier, Jr., MD 10:00 Conference AdjournsConsistent with ACCME and ANCC policy,faculty for this educational activity are asked 6:30 Questions & Answersto disclose any commercial interests that Group Discussionmay create or may be perceived as creating Faculty Panel & Audiencea conflict related to the material they will be Rx= Pharmacology Credit for Prescriptive Authoritypresenting, as well as limitations on clinical 7:15 Adjourn Afternoon Session will be Granted for these Sessionsstudies presented, and any “off-label” usesuggestions for medical products.Additionally, Symposia Medicus Board, Thursday, February 28Planning Committee, and Staff Membershave disclosed that they have no significantfinancial relationships that could pose a 6:30am Continental Breakfastconflict of interest to the planning of thisconference. This information is intended to 7:00 Popular Supplements:assist you in forming your own judgments What’s Hot & What’s Notabout content presented. Disclosure Candy Tsourounis, PharmDinformation will be included in your syllabusand/or verbally disclosed at the conference. 7:45 Social Media Tips for Medical Providers: How You Can Use Social Media to Enhance Your Practice C. David Geier, Jr., MD 8:45 GYN Risk Management: Case Studies Jay Goldberg, MD, MSCP 9:30 Questions & Answers Group Discussion Faculty Panel & Audience 10:15 Adjourn Morning SessionPage 3 Conference Brochure #1249, 2nd Annual Winter Conference on Women’s Health Symposia Medicus 35 Since 1978
  4. 4. CONFERENCE REGISTRATION INFORMATION TERMS & CONDITIONSEnrollment for this conference is limited in order to provide the best possible learning environment. Hotel PoliciesEarly registration is advised. • Group rates are per room, per night, and DO NOT include the following (subject to change without notice):TUITION: EARLY REGULAR - State and local taxes of 12.4% If postmarked by If postmarked after - Resort fee of $20 per room, per night that includes: wireless internet, daily bottled water in guest room, December 18, 2012 December 18, 2012 unlimited local & 800 phone calls, and 24-hour access to the WestinWORKOUT® fitness center Physicians $610 $710 Residents, Nurses, PAs & All Others $510 $610 • Maximum occupancy is based on sleeping beds. An infant in a crib does not count toward total maximum occupancy.• Tuition includes continuing education certification, extensive conference syllabus, break refreshments, breakfast on Wednesday, Thursday, and Saturday, and group reception. The group reception is for faculty, • Rollaways are available at $35 per night (very limited availability). Note: Rollaways are only available for registrants and their guests. 1-, 2-, and 3-bedroom suites. Cribs are available at no charge.• Tuition may be paid by check, money order, Visa, MasterCard, American Express, or Discover. • Valet parking is only available at the Westin Riverfront Resort & Spa. Conference registrants who reserve their room through Symposia Medicus will receive a discounted valet parking fee of $15 per day (regularly $25 per• Register on-line at www.symposiamedicus.org or by using the form in this brochure. day).• Telephone registrations can be made Monday-Friday, 8:30am-5:00pm (Pacific Time), by calling • An early departure fee equal to one night’s room rate will be charged to guests departing before their scheduled (925) 969-1789 or (800) 327-3161. Registrations can also be faxed to (925) 969-1795. departure date. To avoid this fee, guests must advise the hotel at or before check-in of any change in the• If paying by check, make payable and send with registration form to Symposia Medicus, scheduled length of stay. 399 Taylor Blvd., Suite 201, Pleasant Hill, CA 94523-2287. Cancellation Policies• Conference registration will be confirmed via email and more information on travel, hotel, and activities will be emailed and available on our website as well. • Conference cancellations must be confirmed in writing and a 10% of paid tuition processing fee will be assessed. No refunds will be made if cancellation is postmarked after January 22, 2013; however, tuition, less 10%• This conference meets the requirements for CE tax deductibility; however, we suggest you consult your processing fee may be applied to a future Symposia Medicus conference. financial authority for more information. • Per our hotel contract, hotel reservation cancellations must be made in writing to Symposia Medicus and you will• For additional conference or lodging information, call Symposia Medicus at (800) 327-3161 or receive a full refund if postmarked by December 21, 2012. Between. December 22, 2012 and (925) 969-1789, or visit our website at www.symposiamedicus.org. January 22, 2013, one night’s deposit is forfeited. After January 22, 2013, no hotel refunds can be made.• For information on air reservations and ticketing assistance, you may either call your travel agent • All cancellations must be made in writing (via email, fax or mail) and postmarked by the dates stated above. or the airlines direct. Please see the Airline Travel Information portion of this brochure for further information. • In the unlikely event of conference cancellation by Symposia Medicus, full tuition and, if reservation was made with Symposia Medicus, hotel deposit refunds will be made. Symposia Medicus will not be responsible for refunding travel or any other expenses.CONFERENCE LODGING INFORMATIONGroup Rates have been arranged at the Westin Riverfront Resort & Spa. These rates will also be available threedays before and three days after the conference, based on availability, if you wish to extend your stay.Two nights’ deposit (room rate only) must accompany your reservation. The balance of your lodging, hotel fees as AIR TRAVEL INFORMATIONstated below, and all incidental charges are due to the hotel. The hotel accepts most major credit cards. The closest airport is Eagle County Regional Airport, which is an approximate 20 minute drive to Beaver Creek; how-You can receive these rates by reserving the following ways: ever, lower fares can often be found by flying into Denver International Airport, which is approximately a two hour drive to Beaver Creek. Information on ground transportation to Beaver Creek will be sent to registrants and available• On-line at our website, www.symposiamedicus.org; OR online.• Call Monday-Friday, 8:30am-5:00pm (Pacific Time), (925) 969-1789 or (800) 327-3161; OR Symposia Medicus has arranged for discount fares with Alaska, American, Delta, and United Airlines for this con-• Fax form with Visa, MasterCard, American Express, or Discover to (925) 969-1795; OR ference. Reservations can be made either through your travel agency or through the airlines at the website or Convention Desk numbers listed below.• By mail, make check payable to Symposia Medicus and send with registration form to 399 Taylor Blvd., Suite 201, Pleasant Hill, CA 94523-2287. In order to receive the discounted rate, you or your travel agent must refer to the Symposia Medicus Group ID number listed below.Please note that our block of rooms is limited and on a first come, first served basis. PLEASE RESERVEEARLY as rooms may sell out and/or room rates may increase. Alaska Airlines For discounts on Alaska Airlines flights, please book online at www.alaskaair.com and insert ECMU48 into the e-certificate code box. The Westin Riverfront Resort & Spa is a full-service resort with restaurants, a wine bar, a year-round outdoor pool, For questions, please call the fitness center, three oversized hot tubs overlooking the Eagle River, full-service spa, and the Westin Kids Club. Alaska Airlines Convention Desk at (800) 445-4435. MAXIMUM American Airlines For discounts on American Airlines flights, please book online at TYPE OF ROOM GROUP RATES OCCUPANCY DESCRIPTION www.aa.com and insert 9423BL into the promotion code box. For questions, please call the Traditional Room $279/night 4 Approximately 400 sq. ft. with two queen-size beds, American Airlines Convention Desk at (800) 433-1790.Very limited availability. bathroom, mini-fridge, and views of the town of Avon. Please reserve early! Delta Airlines For discounts on Delta Airlines flights, please book online at www.delta.com and click the box “from Airport” and another Studio Suite King $325/night 4 Approximately 450 sq. ft. with a king-size bed and page will appear. At the bottom of that page, click the link bathroom featuring a dual vanity, walk-in glass shower “Meeting Event Code” and insert NME7E. and separate soaking tub. The sitting area has a sofa For questions, please call the bed/love seat, chair, coffee table, and gas fireplace. Delta Airlines Convention Desk at (800) 328-1111. The kitchenette includes a two-burner stove, sink, microwave, mini-fridge, and toaster oven. Views of United Airlines For discounts on United Airlines flights, please book online at the town of Avon. www.ual.com and insert ZNAV840557 in the offer code box. The 1-, 2-, and 3-Bedroom Suites include the following: For questions, please call the Gas fireplace, Bose sound system, washer & dryer, and full kitchen with dining table United Airlines Convention Desk at (800) 426-1122. 1-Bedroom Suite $479/night 4 Approximately 800 sq. ft. suite includes a master bedroom with a king-size bed and bathroom with a dual vanity, walk-in glass shower and separate CAR RENTAL DISCOUNT soaking tub. The living area has two sofas (one with pull-out bed), two chairs, and a coffee table. Views Symposia Medicus has arranged conference discounts with AVIS and Budget Car Rentals. Reservations can be of the town of Avon. made by phone; please refer to the conference code and the conference/airport location when making your reservations. Please see below: 2-Bedroom Suite $733/night 8 Approximately 1,200 sq. ft. suite includes a master bedroom with a king-size bed and bathroom with a AVIS dual vanity, walk-in glass shower and separate 800-331-1600 soaking tub. The second bedroom has two queen-size AWD # B766625 beds, bathroom with combination tub/shower, and separate exit into hotel’s hallway. The living area has BUDGET two sofas (one with pull-out bed), two chairs, and a 800-772-3773 coffee table. The suite also has a balcony or patio BCD # U076767 with views of Eagle River and Game Creek Bowl, Beaver Creek Mountain or Bachelor Gulch Mountain. 3-Bedroom $1155/night 10 Approximately 1,900 sq. ft suite includes a master Luxury Suite bedroom with a king-size bed, a second bedroom Very limited with a queen size bed, a third bedroom with two availability. queen-size beds, and three bathrooms. The oversized Please reserve early! separate living area has two couches (one with full-size pull-out bed), two chairs, and a 42” flat screen TV. The Suite also has a private deck and wrap around windows offering expansive panoramic views of the surrounding mountains and Eagle River. All rooms and suites also include: Westin Heavenly Beds®; Westin Heavenly Baths®; at least one 32” flat screen LCD TV; iHome alarm clock including iPod docking station; work station with chair and desk pad; Starbucks® Coffee; plush robes and slippers; make- up/shaving mirror; full-length mirror; iron/ironing board; operable, oversized windows; in-room safe; housekeeping services are offered twice daily; turndown service is offered 6:00-9:00pm; dogs are allowed free of charge and receive a Heavenly Dog Bed® and water bowl upon arrival, along with doggie welcome kit.Page 4 Conference Brochure #1249, 2nd Annual Winter Conference on Women’s Health Symposia Medicus 35 Since 1978
  5. 5. CONFERENCE LOCATION This exciting conference will be held at the beautiful Westin Riverfront The Westin’s Spa Anjali provides soothing mountain-inspired treatments Resort & Spa, nestled at the base of Beaver Creek Mountain, with the featuring local botanicals in a luxurious 23,000 square foot facility designed Eagle River running the entire length of the resort. Located on the Westin to relax, rejuvenate and restore body, mind and spirit. Or enjoy a healthful Plaza, the Riverfront Express Gondola whisks skiers and riders to the slopes workout in the WestinWORKOUT® fitness center or the year-round outdoor of Beaver Creek Mountain, Bachelor Gulch and Arrowhead ski areas, 25-yard lap pool. providing access to more than 1,800 acres of skiable terrain - perfect for novice to experienced skiers. Cross-country and snowshoeing After a full day of wintertime fun, you can enjoy a relaxing afternoon or enthusiasts can enjoy lift access to McCoy Park for an equally enjoyable evening at the Westin’s Lobby Wine Bar. Or take pleasure in a fine dining outdoor experience. Other nearby activities to enjoy include snowmobiling, experience at the Westin’s Cima Restaurant. Chef Richard Sandoval, dog sledding, sleigh rides, fly fishing, and ice skating. famous for his Latin cuisine, prepares his dishes with fresh market produce, sustainable seafood, grass fed meats and specialty products from Only 20 minutes away is Vail Ski Resort, the largest single mountain in local purveyors. You can also enjoy great dining in Avon, with its assortment North America, where you will be challenged by 193 trails over nearly of boutiques and beautiful sprinkled shops, boutiques, and beautiful bronze 5,300 acres of skiable terrain. With so many wintertime activities sculptures. available, you will see why the Westin Riverfront Resort & Spa was named one of the “10 Best Snow Resorts for Families”. Whatever your pleasure, you’ll be sure to find it in Beaver Creek, Colorado at our 2nd Annual Winter Conference on Women’s Health. In your guest room, indulge yourself with the signature Westin Heavenly Bed® and the Heavenly Bath®, a truly luxuriant treat. Plush bathrobes & slippers, oversized cotton towels, refreshing White Tea Aloe bath amenities by Bliss, and turndown service complement your Westin experience. 2012 CALENDAR OF FUTURE CONFERENCES (For our complete calendar of conferences, please visit www.symposiamedicus.org) 1230 Current Issues in Women’s Health Care Mediterranean Cruise (Celebrity Cruises – Silhouette) Sep 29-Oct 11 1231 23rd Annual National Conference on Women’s Health Care Las Vegas, Nevada Oct 1-3 1236 Challenges in Obstetrics & Gynecology Eastern Caribbean Cruise (Celebrity Cruises – Eclipse) Nov 9-17 1239 19th Annual Fall Conference on High Risk Pregnancy Marco Island, Florida Nov 14-17 1241 18th Annual Conference on Care of Women Over 50 Guanacaste, Costa Rica Nov 28-Dec 1 1243 18th Annual Conference on Challenges in Gynecology New York City, New York Dec 14-15 2013 CALENDAR OF FUTURE CONFERENCES 1245 20th Annual Office GYN & Women’s Health for the Primary Care Provider Puerto Rico Feb 6-9 1246 17th Annual Winter OB/GYN Conference Aruba, Dutch Caribbean Feb 6-9 1251 20th Annual Spring Conference on High Risk Obstetrics St. Martin, Caribbean Mar 6-9 1252 20th Annual Spring Conference on Women’s Health Big Island, Hawaii Mar 13-16 1257 14th Annual National Conference on Fetal Monitoring Las Vegas, Nevada Apr 18-20 1259 Challenges in Gynecology Las Vegas, Nevada Jun 6-8 1263 20th Annual Summer Conference on Obstetrics and Gynecology Jackson Hole, Wyoming Jun 26-29 1262 14th Annual Summer Conference on Women’s Health Big Sky, Montana Jul 10-13 1265 Current Issues in Women’s Health Care Alaska Cruise (Celebrity Cruises – Solstice) Jul 26-Aug 2 1267 14th Annual Conference on Integrative Medicine in Women’s Health Napa, California Sep 11-14 1269 24th Annual National Conference on Women’s Health Care Las Vegas, Nevada Sep 16-18 1270 27th Annual Fall Conference on High Risk Obstetrics Hilton Head, South Carolina Sep 26-28 1271 Challenges in Obstetrics and Gynecology Mediterranean Cruise (Celebrity Cruises – Reflection) Sep 20-30 1272 31st Annual Fall Conference on Obstetrics Big Island, Hawaii Oct 16-19 1276 21st Annual Fall Conference on Issues in Women’s Health Guanacaste, Costa Rica Oct 30-Nov 2 1278 20th Annual Fall Conference on High Risk Pregnancy Marco Island, Florida Nov 13-16 1275 Hot Topics in Pediatric Emergency Medicine & Nursing Eastern Caribbean Cruise (Celebrity Cruises – Reflection) Nov 16-23 1280 19th Annual Conference on Care of Women Over 50 Playa del Carmen, Mexico Nov 20-23 1282 19th Annual Conference on Challenges in Gynecology New York City, New York Dec 20-21 For more information on any of these conferences, please write to: Symposia Medicus, 399 Taylor Blvd., Suite 201, Pleasant Hill, CA 94523-2287; call (800) 327-3161 or (925) 969-1789; email us at info@symposiamedicus.org; OR visit our website at www.symposiamedicus.org to view brochures of upcoming conferences. Brochures are available 6-8 months prior to conference.Page 5 Conference Brochure #1249, 2nd Annual Winter Conference on Women’s Health Symposia Medicus 35 Since 1978
  6. 6. CONFERENCE & LODGING REGISTRATION FORM SYMPOSIA MEDICUS Register on-line at www.symposiamedicus.org 2 Annual Winter Conference on nd OR complete this form and mail or fax with appropriate payment to: WOMEN’S HEALTH Symposia Medicus Westin Riverfront Resort & Spa 399 Taylor Blvd., Suite 201 35 Pleasant Hill, CA 94523-2287 Beaver Creek, Colorado Phone (925) 969-1789 or (800) 327-3161 • Fax (925) 969-1795 FEBRUARY 26-MARCH 2, 2013 PLEASE PRINT LEGIBLY: (Show name and one degree as you would like it printed on your conference materials): Registrant’s Name: ______________________________________________________________________________ Degree: ________________________ First Last E-mail Address (required): __________________________________________________________________________________________ In order to receive registration confirmation, as well as access to CME credit, activity and conference information, the REGISTRANTS single and unique email address must be provided. Mailing Address: ______________________________________________________________________________________________________________ Street City State Zip If this is a hospital or office address, please show name/suite # here:________________________________________________________________________ Primary Work: (______) ________________________________________ Home: (______) ________________________________________________ Cell: (______) ________________________________________________ Fax: (______) __________________________________________________ Professional Name of Hospital Specialty: ______________________________________ or Workplace:__________________________________________________________________ Our conference syllabus will be available for download on our website approximately two weeks before the conference. Please check here if you prefer a paper syllabus. #1249 LODGING RESERVATIONS Please reserve accommodations at the Westin Riverfront Resort & Spa for: Arrival:____________________ ________/________/______ Departure:_______________________ ________/________/______ (DAY of the week) Month Day Year (DAY of the week) Month Day Year ROOM TYPE (check one): TYPE OF ROOM GROUP MAX. • Group rates are per room, per night, and DO NOT include the following (subject to RATES OCCUPANCY change without notice): - State and local taxes of 12.4% * Traditional Room $279/night 4 - Resort fee of $20 per room, per night that includes: wireless internet, daily bottled Studio Suite King $325/night 4 water in guest room, unlimited local & 800 phone calls, and 24-hour access to the WestinWORKOUT® fitness center 1-Bedroom Suite $479/night 4 • Maximum occupancy is based on sleeping beds. An infant in a crib does not count toward total maximum occupancy. 2-Bedroom Suite $733/night 8 • Rollaways are available at $35 per night (very limited availability). Note: Rollaways are * 3-Bedroom Luxury Suite $1155/night 10 only available for 1-, 2-, and 3-bedroom suites. Cribs are available at no charge. * Very limited availability. Please reserve early! Names of All Room Occupants (and ages, if children) ____________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________ Please circle names of room occupants (other than you) who are registered for this conference Other Comments/Requests ________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________________________________ TUITION AMOUNT DUE TWO NIGHTS’ LODGING DEPOSIT - ROOM RATE ONLY TOTAL (Note: Balance of hotel charges will be due to hotel) $ $ $ Payment Type: ____ Check (Please Enclose) ____ ____ ____ ____ Cardholder Name: ________________________________________________ Signature:______________________________________________________ Billing Address: ________________________________________________________________________________________________________________ (If different from above) Street City State Zip Card Number Expiration Date Security # Month/Year (on front or back of card) / ALL INFORMATION STATED ABOVE WILL REMAIN CONFIDENTIAL TO SYMPOSIA MEDICUS By registering, you agree to the Terms & Conditions as stated in this brochure. Copies of this form can be used for additional registrations • Telephone registrations may be taken with Visa, MasterCard, American Express, or Discover by calling Monday-Friday, 8:30am-5:00pm (Pacific Time) • Phones: (800) 327-3161 or (925) 969-1789, or Fax (925) 969-1795 Visit our website for other educational conferences and/or to register on-line at: www.symposiamedicus.orgPage 6 Conference Brochure #1249, 2nd Annual Winter Conference on Women’s Health Symposia Medicus 35 Since 1978

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