Relative Analgesisa Workshop The objective of the course is to enable participants to become proficient and confident in the administration of nitrous oxide in clinical practice. This course is approved by the Australian Society of Dental Anaesthesiology and provides an efficient introduction to dental relative analgesia. The course is also an excellent refresher for dentists wishing to update their theory and practical skills in the delivery of relative analgesia. Participants will be given the opportunity to administer nitrous oxide-oxygen sedation to each other, and to experience themselves the effects of the gases in a safe environment. DATES Friday 28 November 2014 TIME 8:15 am - 5:00 pm VENUE ADAVB Meeting Rooms Level 3, 10 Yarra Street South Yarra PRESENTERS Dr Michael Walker Dr Angelo Preketes Presenter Dr Michael Pitt Walker BDS, FPFA Dr Walker is a Conscious Sedation Practitioner endorsed by the Dental Board, Past President of ASDA and Senior Clinical Associate, External Examiner to the Diploma in Conscious Sedation University of Sydney. Dr Walker runs one of the largest sedation practices in the Sydney region, where nitrous oxide sedation forms an integral part of his practice used on a daily basis. Dr Angelo G Preketes BDS(Syd) Dr Preketes is the Secretary for ASDA and sits in the Dental Practice Committee for the ADA , And is currently teaching the University of Sydney Bachelor of Dentistry students in managing medical emergencies at westmead hospital . Dr Preketes is in private practice focusing on providing pain management techniques to deal with phobic , anxious patients as well as implant and general dentistry . CPD 6.5 Hours FORAMT Workshop ADAVB Member Limited to 25 RSVP by Monday 6 October Full calendar is available on www.adavb.net For more information about any of the CPD activities please contact the ADAVB on (03) 8825 4600 Disclaimer: ADAVB is not responsible for changes to course details made after going to print. FEES $990 REGISTRATION FORM / TAX INVOICE ABN 80 263 088 594 ARBN 152 948 680 Red’d Assoc No. A0022649E PLEASE USE BLOCK LETTERS WHEN FILLING IN YOUR DETAILS PRIMARY REGISTRANT o I am a member of my ADA state branch. o Dentist o Hygienist o Retired/Student Member o Dental Assistant o Other MEMBER NUMBER HOW TO ENROL Telephone registrations are not accepted Given Name (Dr/Mr/Ms/Mrs) Family Name FAX 03 8825 4644 Mailing Address State: P/Code: EMAIL cpd@adavb.org Work Phone Fax Mobile ONLINE www.adavb.net Email MAIL ADAVB (IMPORTANT: YOUR CONFIRMATION AND REMINDER WILL BE SENT TO THIS EMAIL) PO Box 9015 South Yarra, VIC 3141 For further Information, please call (03) 8825 4600 Special Dietary Requirements ACCOMPANYING STAFF DETAILS Given Name PLEASE NOTE Your registration for these events indicates acceptance of ADAVB’s Terms and Conditions and Cancellation Policy (Dr/Mr/Ms/Mrs) Family Name Mobile Email Make a copy of this registration form and maintain it for your records. Special Dietary Requirements Dental Assistant Practice Staff (if required please include additional staff members on a separate piece of paper attached to this form) PLEASE ENROL ME IN Course Name Course Date Course Fee Accompanying Staff Fee Total Fee . / / $ $ $ . / / $ $ $ . / / $ $ $ . / / $ $ $ . / / $ $ $ This is a TAX INVOICE for GST upon payment. All rates are GST inclusive. TOTAL (inc GST) $ PAYMENT DETAILS Cheque (made payable to ADAVB Inc) Credit Card MasterCard Visa American Express (DINERS CLUB NOT ACCEPTED) Card Number Expiry Date / Cardholder Name Signature: Date: / / Australian Dental Association Victorian Branch Inc. Level 3, 10 Yarra Street (PO Box 9015), South Yarra Victoria 3141 Tel 03 8825 4600 Fax 03 8825 4644 cpd@adavb.net www.adavb.net