Registration fee includes admission to regular conference sessions, refreshment breaks, poster session reception, daily continental breakfast, course syllabus, and materials provided in each session. Limited enrollment is available. Register early to ensure your participation. Online registration will close on Tuesday, November 11, 2008 at Noon. For onsite registration, there will be a $100 administrative fee added to your registration. Cancellations before October 31 will incur a $75 administrative fee. NO REFUNDS after October 31, 2008

FIRST NAME:
PREFERRED NAME (For Badge):
LAST NAME:
CREDENTIALS / TITLES:
ORGANIZATION:
MAILING ADDRESS:
CITY:
STATE:
ZIP:
WORK PHONE:
CELL PHONE:
EMAIL:
EMERGENCY CONTACT:
Last Four Numbers of Your Social Security Number (Required for CME Credit Tracking):
If you have special needs that may affect your participation, please givea short description below. A conference specialist will contact you to discuss accommodating your needs.
PRE-CONFERENCE
COURSES : WEDNESDAY,
NOVEMBER 12, 2008

COURSE 1 : Essential Procedures for the Hospitalist

$495 - Session I: 8:00 a.m.-12:00 p.m.

$495 - Session II: 1:00 p.m.-5:00 p.m.

COURSE 2 : Inpatient Billing and Coding

$295 - 1:00 p.m.-5:30 p.m. ($345 After September 15th)

MAIN
CONFERENCE
REGISTRATION

$450 - Physician SHM Member or Emory & Ochsner Faculty ($525 After Sept. 15th)

$550 - Non-SHM Physicians ($625 After Sept. 15th)

$295 - RN, NP, PA, PharmD, Pharmacist ($350 After Sept. 15th)

$150 - Residents/Fellows

$25 - Students

SOCIETY OF HOSPITAL MEDICINE
MEMBERSHIP NO.

(Will be verified)

BREAKFAST WITH
THE PROFESSOR

Friday, November 14, 7:00 AM - 7:55 AM (no additional registration fee)

Limited to 30 participants; pre-registration is required

Session A: Difficult Perioperative Cases

Session B: Heparin-Induced Thrombocytopenia

Session C: Inpatient and Perioperative Delirium

THE SHM
LUNCHEON

Friday, November 14, 12:05 PM - 2:00 PM (no additional registration fee)

Limited to 100 participants; pre-registration is required;

SHM Web Based Resources: View Details of Luncheon SHM Web Based Resources: Tools to Improve the Quality Gap in Heart Failure :
Presented by the content expert of the SHM Heart Failure Quality Improvement Resource Room, Nurcan Ilksoy, MD. Come and learn about the Heart Failure Resource Room and how to utilize the resources and clinical tools to improve care for hospitalized patients with heart failure. Bridge the quality gap and make a difference at your institution!

JOB FAIR

Thursday, November 14, 5:45 PM - 6:45 PM (no additional registration fee)

Yes: I will be attending the Job Fair

POSTER SESSION
RECEPTION

Thursday, November 14, 6:30 PM - 8:00 PM (no additional registration fee)

Yes: I will be attending the Poster Reception

CREDIT CARD TYPE
CANCELLATION POLICY

Cancellations before October 31 will incur a $75 administrative fee. There will be NO REFUNDS after October 31, 2008

CREDIT CARD NO.
EXPIRATION DATE
NAME ON CARD

(You Credit Card Will Not Be Charged)

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