Self-Assessment Module 4:30 pm Adjourn THIS IS NOT A SELF-MAILER - Address to: 3:00 Highest Degree Post Conference Sessions for attendees wishing to obtain SAM credit: MI 3:00Adjourn First Q & A Panel Last Name 2:30 How To Start A Successful Breast I-125 Radioactive Seed Localization Program In Your Institution Coding and Billing Christie M. Canady Specialty 2:00 Department (include box no.) Pitfalls, Potential Issues and How To Take Precautions Wei Yang, MD oNo 1:30 oYes VideoCast Physician 1:00 Please visit www.mdanderson.org/conferences to register or mail form to: CME/Conference Management- Unit 1781, The University of Texas MD Anderson Cancer Center, PO Box 301407, Houston, TX 77230-1407. You may also fax the form to 713-794-1724. Institution Lunch / Q&A Panel Discussion Morning Speakers Registration State/Foreign Country/Zip or Mail Code 12:15 pm A course evaluation form will provide participants with the opportunity to comment on the value of the program content to their practice decisions, performance improvement activities, or possible impact on patient health status. Participants will also have the opportunity to comment on any perceived commercial bias in the presentations as well as to identify future educational topics. City Radiation Safety and Regulation Sandra M. Jimenez Street 11:45 Evaluation Upon request, a record of attendance (certificate) will be provided on-site to other health care professionals for requesting credits in accordance with state nursing boards, specialty societies, or other professional associations. Department of CME/Conference Management-Unit 1781 The University of Texas MD Anderson Cancer Center PO Box 301407, Houston, TX 77230-1407 or fax to 713-794-1724 Make check or money order payable to: The University of Texas MD Anderson Cancer Center Management of Seed in the Specimen: Work-Flow in Pathology Michael Gilcrease, MD, PhD Lecture/Didactic, Audience Response System, Panel Discussion, Question/Answer Sessions Fax (with area code) 11:15 Educational Methods Cell Phone (with area code) RSL-Guided Surgery: Nuts and Bolts Shon Black, MD Registration Fees (No SAM) Credit 10:45 This conference will be beneficial to Radiologists, Surgeons, Pathologists, Radiation Safety Officers, and Hospital Administrators 1 Postmarked on or before April 10, 2015.............$395 1 Postmarked after April 10, 2015..........................$495 Seed Workflow in Radiology: From Seed Ordering to Placement Mark J. Dryden, MD 10:15 Phone (with area code) Charge the following: oVISA oMasterCard oAmerican Express Credit Card Holder Billing Address & ZIP Code Certificates awarding AMA PRA Category 1 Credits TM, SAM credits and certificates documenting attendance will be distributed to participants when an individual departs the conference. To obtain a CME certificate, physicians must submit a completed evaluation questionnaire and a CME Verification Form. SAM Credit Registration Fees 10:00Break Target Audience CME Certificates and Attendance Verification Certificates Expiration Date Authorized Usership: Definition and Responsibilities within Breast RSL Framework Eric Rohren, MD, PhD 1 Postmarked on or before April 10, 2015.............$525 1 Postmarked after April 10, 2015..........................$625 9:30 Submitted to the ABR for approval in meeting the criteria for self-assessment toward the purpose of fulfilling requirements in the ABR Maintenance of Certification program. Fund Type Seed Storage, Calibration and Tracking Bill Erwin Fund 9:00 Fund Group* SAM Credits Trainee Registration Fees* Initiating and Completing DSHS Application Sandra Jimenez MD Anderson Employee ID No. (REQUIRED) 8:30 1 Postmarked on or before April 10, 2015.............$295 1 Postmarked after April 10, 2015..........................$375 IDT Approver E-mail This conference has been certified for the level 2 classification in accordance with the AMA guidelines for Continuing Medical Education on New Procedures and Skills. *All trainees must submit a letter of validation from their department chair. After participating in the activity, the participant should be able to: • Initiate and complete a DSHS application (knowledge, competence, performance); • Apply a pathway of seed ordering, storage, assay and tracking (knowledge, competence, performance); •Implement principles of seed localization procedure (RSL) (knowledge, competence, performance); •Understand principles of seed-guided surgery (knowledge); •Incorporate necessary steps to ensure safe seed handing in pathology (knowledge, competence, performance and patient outcomes). Daytime Phone (with area code) How to Start a Breast I-125 RSL Program In Your Institution: An Overview Basak E. Dogan, MD E-mail Address (please print) 8:00 Emergency Contact Welcome and Announcements Wei Yang, MD Credit Card Holder Name (First/Last) 7:50 Credit Card Number Registration and Continental Breakfast Department Educational Objectives The University of Texas MD Anderson Cancer Center designates this live activity for a maximum of 8.5 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 7:30 am Business Unit The University of Texas MD Anderson Cancer Center is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. How To Start A Successful Breast I-125 Radioactive Seed Localization Program In Your Institution - May 9, 2015 MD Anderson Interdepartmental Transfer (IDT) No.: *Fund Group 90 will not be accepted Participants should come away from this course with a clear understanding of the regulations, application process, seed protocoling and procedure planning by the radiologist, seed insertion, surgical techniques and principles, pathology processing and seed storage/ dispensing, associated with performing RSL procedure. Agenda Authorized Signature REQUIRED for credit card or IDT Accreditation/Credit Designation IDT Approver Name (First/Last) please print Goal