COURSE FEES: (Please check) CO - University of Missouri

ACCREDITATION/CONTACT HOURS
The Office of Continuing Education, School of Medicine, University of Missouri is accredited
by the Accreditation Council for Continuing Medical Education (ACCME) to provide
continuing medical education for physicians.
The Office of Continuing Education, School of Medicine, University of Missouri
designates this live educational activity for a maximum of 15.5 AMA PRA Category 1
Credits™ (3.5 credits for pre-conference session; up to 5.25 for Friday general sessions;
up to 6.75 for Saturday general/concurrent sessions). Physicians should only claim
credit commensurate with the extent of their participation in the activity.
University of Missouri Sinclair School of Nursing is an approved provider of continuing
nursing education by the Midwest Multistate Division, an accredited approver by the
American Nurses Credentialing Center’s Commission on Accreditation.
Up to 15.25 Contact Hours will be awarded to all individuals (3.33 for preconference session; 5.16 for Friday general sessions; 6.75 for Saturday general/
concurrent sessions). Midwest Multistate Division Approval Number 716-VII.
This is being reviewed for credits by the American Academy of Family Physicians.
This activity has been reviewed by the University of Missouri School of Social Work for
continuing education units for social workers , and is approved for 13 contact hours
(1.3 CEUs).
This activity is being reviewed by the University of Missouri School of Health
Professions for contact hours.
This activity is being reviewed by the AMDA for Certified Medical Director in LongTerm Care (CMD) credits, and the number of hours will appear later on our website.
This program is being reviewed by the Missouri Board of Nursing Home
Administrators for credits.
LOCATION AND LODGING
Holiday Inn Executive Center
2200 I-70 Drive Southwest, (Hwy. 70 and Stadium Blvd. Exit)
Columbia, Missouri 65203
(573) 445-8531 • FAX [573] 445=7607
Rates: Guest rooms have been reserved for three nights, August 13, 14, 15,
2015. Nightly rates are $97.95, plus tax. Check-in time is 4:00 pm; check-out
time is 11:00 am.
Deadline: Reservations made after Wednesday, July 15, 2015, will be provided
on a space available basis only. To ensure you receive the conference rates
listed, be certain to make your reservation under group name “ELS.”
REGISTRATION INFORMATION
To register, please complete and return the registration form with payment to
the address listed at the bottom of the form or fax your form to [573]882=5666.
You may also register online at medicine.missouri.edu/cfe. The last day for online
registration is Sunday, August 9, 2015.
SUBSTITUTION AND CANCELLATION REFUND POLICY
If you register but cannot attend, you may substitute another individual from
your organization. A substitution must be made in writing and mailed to the
address listed on the registration form.
A full refund of fees less a $25.00 administrative fee will be made if notice
of cancellation is received, in writing, by Friday, August 7, 2015. A $50.00
administrative fee will be assessed for any cancellations received after Friday,
August 7, 2015 and until Tuesday, August 11, 2015. No refunds will be made after
Tuesday, August 11, 2015.
Questions? Call (573) 882-4105
Approved credits will appear on our website: medicine.missouri.edu/cfe.
REGISTRATION FORM
Caring for the Frail Elderly — August 14-15, 2015
Name _________________________________________________________________________
First
Last
MI
Name & Degree for name tag _______________________________________________________
Office Name____________________________________________________________________
Office Address ­___________________________________________________________________
Please indicate if any special arrangements are required to attend this
conference:
________________________________________________
________________________________________________
CONCURRENT SESSIONS – August 15
E-mail Address __________________________________________________________________
(Check the session you are likely to attend for each time segment.)
9:30am • CONCURRENT SESSION 1
___ Village Concept
___ Managing Incontinence in the Older Adult
___ Peripheral Arterial Disease
___ First-time conference registrant
10:45am • CONCURRENT SESSION 2
______________________________________________________________________________
City
State
ZIP
County
Office Phone (_______)______________________ FAX(_______)__________________________
___ I DO NOT want my name on the conference roster
COURSE FEES: (Please check)
___ Neglect, Abuse, Financial Exploitation and Plans of Action
____ $50 Pre-conference Session: Palliative Care
(limited to 40 participants; call (573)882-5661 to check availability)
___ Statins and Hyperlipidemia Management
Caring for the Frail Elderly Conference
Received on/before July 18 (postmarked date):
____ $290- Physician ____ $220- Other health professional
2:00pm • CONCURRENT SESSION 3
Received after midnight on July 18:
____ $355- Physician ____ $285- Other health professional
___ Advanced-care Planning in the Outpatient Setting
TOTAL ENCLOSED
$ _____________
Fees include conference materials
and all catered food functions.
___ New Tech for Old Timers
___ Communicating with Challenging Families of Long-term Care Residents
___ Literature Update
____ I will attend the Friday evening Poster Session & Reception (4:40 pm)
3:00pm • CONCURRENT SESSION 4
____ I will attend the Friday evening MALTCP meeting (5:40 pm)
___ Coding/Billing
___ Multi-disciplinary Session
____ I will attend the Saturday MALTCP meeting (noon)
____ Check enclosed (Make payable to the University of Missouri)
Please charge my: ___Discover ___MasterCard ___American Express
___Visa
Print name as it appears on card ________________________________________________________
Mailing address if different from above: _______________________________________________
___________________________________________________________________________
Account Number ____________________________________________ Exp. Date ___________
Mail completed registration form and payment to:
Frail Elderly Conference
University of Missouri, Office of Continuing Education
2401 Lemone Industrial Blvd., DC345.00
Columbia, MO 65212
You may also register by FAXing your completed form
to [573] 882=5666
or online at medicine.missouri.edu/cfe