Oncology Conference How To Register: April 12 - 13, 2013 - Travelodge Hotel - Saskatoon Phone: (306) 966-7790/(306) 966-7795 Fax: (306) 966-7673 Email: [email protected] Contact Details Dr. Mr. Ms. Mail: Continuing Professional Learning College of Medicine, University of Saskatchewan Box 60001 RPO University Saskatoon, SK S7N 4J8 First Name Last Name Mailing Address City Area Code Prov Telephone Area Code Postal Code Fax - - E-mail Address (Required) Registration Fees U of S GST # 11927 9313 RT0001 Please note that we accept payment only by credit card or institutional cheque payable to Continuing Professional Learning. Registration will not be processed until payment is received.  Physicians: Before and on March 28 $420.00 ($400.00 + 20.00 GST) March 28 and after $472.50 ($450.00 + 22.50 GST)  Nurses, Pharmacists and other Health Professionals: $304.50 ($290.00 + 14.50 GST) $357.00 ($340.00 + 17.00 GST  Residents & Students: $131.25 ($125.00 + 6.25 GST) (PROOF OF FULL-TIME STUDENT OR RESIDENT STATUS REQUIRED) Family Physician Specialist* _________________ Pharmacist FLAT RATE Other* ____________________ Resident *__________________ Student *___________________ Nurse/NP Physiotherapist Social Workers *(Please Specify) Payment Information $ Total Amount Enclosed ___________________ Credit Card Payment: VISA Expiry MM/YY MC  Institutional Cheque Card Number Signature Cancellation & Refund Policy *REQUIRED Cancellations must be received in writing by April 4, 2013, and will be subject to a $75.00 administration fee. Refunds will not be considered on or after April 5, 2013. The conference organizers reserve the right to cancel or postpone this course due to insufficient registration or circumstances beyond our control. This course may be cancelled up to twenty (20) days prior to the course date. In such case each registrant will be notified by telephone or email with written notification and a full refund following. The conference organizers are not responsible for any other costs including but not limited to airline or hotel penalties. Oncology Conference April 12 - 13, 2013 - Travelodge Hotel - Saskatoon Print Name Here _____________________________________________________________ Please indicate any food allergies or restrictions:__________________________________ USE THIS FORM TO SELECT YOUR CONCURRENT SESSIONS. Please indicate your first and second choices, using a 1 or 2, for each set of concurrent sessions. Please Note: Program content and speakers are subject to change. Friday, April 12, 2013 Concurrent Sessions - A - Case Discussions (Choose two) _____ A-1 Prostate Cancer Update - Dr. Shari McKinny _____ A-2 Treatment of Colorectal Cancer - Case Studies & Treatment Options - Dr. Janine Davies A-3 When Pediatric Cancer Survivors Become Adults - Dr. Roona Sinha, Dr. Tanya Brown, & Rick Pryor _____ _____ A-4 Thrombosis in the Cancer Patient - Dr. Otto Moodley Concurrent Sessions – B - Case Discussions (Choose two) _____ B-1 Targeted Therapies for Cancer - Toxicity Profiles & Management - Kathy Gesy _____ B-2 Breast Cancer Update - Dr. Michael Harington & Dr. Kamal-Uddin Haider _____ B-3 Lung Cancer Update - Dr. Renee Kennedy & Dr. Amer Sami _____ B-4 Oncologic Emergencies & Red Flags - Dr. Theresa Bradel & Dr. Joanne McLeod Saturday, April 13, 2013 Concurrent Sessions – C - Case Discussions (Choose two) _____ C-1 Gynecological Cancer Update - Dr. Maryam Al-Hayki & Dr. Shazia Mahmood _____ C-2 Hematological Cancers Update - Dr. Rebecca MacKay _____ C-3 Sexual Dysfunction - Dr. Trustin Domes & Dr. Christopher Giede _____ C-4 Supporting Patients with a Long Cancer Journey - Bruce Schmidt