May 13th 2015 • The Crowne Plaza Hotel at the Crossing . PharMerica Education Symposia & Exhibition Series Registration Fee Agenda The cost for participation is $0 to all registrants who register BEFORE Friday, April 24th. All registrations must be postmarked no later than April 24th in order to receive the Early Bird Registration. 7:15am 7:30am Registrations postmarked or made online after Friday, April 24th will be subject to the full registration fee of $25 per participant. The registration deadline is Friday, May 8th. All registrations include: The opportunity to earn up to 6 CEUs, breakfast and lunch buffet, and a welcome gift. Make Your Reservations Early!! PharMerica has arranged for a special group rate of $151.00 per night single or double occupancy plus appropriate tax and service charge. This rate will be extended for three days prior to and after the conference dates, based on hotel availability. Reservations must be made by Saturday, April 11th, 2015. Reservation requests made after the deadline will be based on availability at the prevailing rate determined by the hotel. To make your hotel reservations, call The Crowne Plaza at the Crossing at 401.732.6000. Hotel Information The Crowne Plaza at the Crossing 801 Greenwich Avenue Warwick, RI 02866 Hotel: 401.732.6000 Registration Payment Payment for the symposium can be made by U.S. Check, American Express, Visa, or MasterCard and must be submitted with your registration. PharMerica will not process your registration without full payment. To avoid duplicate charges to your credit card, DO NOT mail a copy of your registration form once it has been completed online. A confirmation will be e-mailed to you within 15 days of receipt. Substitutions Substitutions will be allowed up to one (1) calendar day prior to the conference. Conference registration changes and/or substitutions must be made in writing via email to lindsey.richcreek@pharmerica.com. Cancellations/Refunds Any change or cancellation must be made in writing and emailed to lindsey.richcreek@pharmerica.com. Refunds will not be issued after Friday, May 8th, 2015. Refunds will be processed within 15 days from date of request. Refunds or credits will not be made on no-shows. Registration Breakfast Buffett “Promotional Educational Program” - TBA 8:30am “Diabetes Challenges Improving Outcomes in Older Adults” Scott Drab, PharmD.,CDE, BC-ADM – 1.5 CE Hours 10:00am Break Vendor Interaction 11:00am “Antipsychotic Management” Charles Crecelius, MD, PhD, FACP, CMD – 1.5 CE Hours 12:30pm Lunch Promotional Educational Program - Pfizer 1:30pm “INTERACT” Richard Stefanacci, DO, MGH, MBA, AGSF, CMD – 1.5 CE Hours 3:00pm Break 3:15pm “Understanding COPD: Best Practices and Reducing Readmissions” Gary Greenspan, MD - 1.5 CE Hours Conference Attire Casual attire is suitable for all meetings, sessions, and meals. Nursing scrubs are also accepted. Please remember to bring a sweater or jacket for air-conditioned rooms. Continuing Education Credits (CEU Credits) PharMerica has requested up to 6 hours of CEU hours of continuing education for all nurses and nursing home administrators. Individuals seeking approval for all other professional licensures must file independently and should contact Lindsey Richcreek, Lindsey.richcreek@pharmerica.com, Marketing Coordinator, for the materials needed. CE Statement National Association of Directors of Nursing Administration LTC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. NADONA/LTC is a Certified Sponsor of professional continuing education with the National Association of Long Term Care Administrator Boards (NAB) and has approved this program for the number of clock hours listed under their sponsor agreement with NAB/NCERS. State licensure boards, however, have final authority on the acceptance of individual courses. In accordance with the PhRMA Code on Interaction with healthcare professionals, attendance at this education program is limited to healthcare professionals. Accordingly, attendance by guests or spouses is not appropriate. PharMerica is a Commercial Supporter and has provided an education grant for this program. 1901 Campus Place, Louisville KY 40299 • 502.627.7743 • www.PharMerica.com/events May 13th 2015 • The Crowne Plaza Hotel at the Crossing . PharMerica Education Symposia & Exhibition Series Registration Information Please PRINT. Registration will not be accepted unless license number is provided and ALL fields are completed. Full Name____________________________________________________ Registration Type Please read cancellations/refunds policy under General Information. o o Early Bird (Postmarked by 04/24/2015): Late Registration: Nickname for Badge_________________ Title_____________________ Organization Name___________________________________________ Organization Address_________________________________________ City___________________ State________ Zip Code________________ Telephone_____________________ Fax_________________________ Email________________________________________________________ License #_____________________________________________________ Signature_____________________________________________________ Are you a customer of PharMerica? o Yes o No Do you have any dietary restrictions? o Yes o No o If yes, please specify______________________________________ Have you attended a PharMerica Symposia before? o Yes o No 1. Registrant’s Position: Check only one. o Facility Owner/CEO o Administrator o Assistant Administrator o Director of Nursing o Other______________________________________ 2. Type of Facility: Check all that apply o Skilled Nursing Center o Assisted Living/Residential Care o Skilled Nursing Center and Assisted Living Community o Sub-Acute Care o Continuing Care Retirement Community o Other_______________________________ Total: $___________________ Payment Options Registrations without payment will NOT be processed. o Check (attached) Please charge my: o American Express ○ Visa ○ MasterCard Account Number:_______________________________________ Exp. Date:______________ Sec. Code:_____________________ Name as it appears on Card (please print)_____________________ Signature of Cardholder___________________________________ Billing Address (if different from organization address) _______________________________________________________ City_____________ State_______ Zip Code_________________ Registrations without payment will NOT be processed. Online: www.pharmerica.com/events Mail Application and payment to: PharMerica ATTN: Lindsey Richcreek 1901 Campus Place Louisville, KY 40299 Questions Visit www.pharmerica.com/events, or email lindsey.richcreek@pharmerica.com , or call 502.627.7743 or fax 502.261.2469 3. How did you hear about the PharMerica Symposium? o Direct Mail o Fax o PharMerica Website o PharMerica Representative o Other ______________________________ 1901 Campus Place, Louisville KY 40299 • 502.627.7743 • $0.00 $25.00 www.PharMerica.com/events
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