Trends & Treatment Series - Registration Form

"Delivering Bad News"
presented by
Howard Beckman, MD, FACP, FAACH
Recipient of the Lynn Payer Award from the
American Academy of Communications in Health Care

Nursing and RT 1.5 Contact Hours Provided
Thursday, November 15, 2012
6:00 p.m. Light Refreshments
6:30 -8:00 p.m. Interactive Session
John D Dingell VA Medical Center
Auditorium • Lower Level • Yellow Section
4646 John R Street, Detroit, MI 48201
Parking in the Blue Lot will be validated.

First Name*

Last Name*

Your Job Title

Your Workplace

Street Address*

City, State, Zip*

Your Email Address*

Your Phone No:

Your AARC No:

Select your CEU:

RT CEU

RN CEU

* Application has been made to the American Association for Respiratory Care (AARC) for 1.5 continuing
education contact hours for respiratory therapists.

*This activity has been submitted to WNA CEAP for approval to award contact hours. Wisconsin Nurses
Association is accredited as an approver of continuing nursing education by the American Nurses
Credentialing Center’s Commission on Accreditation.

Planners: Mary Vidaurri, RN, PhD; Sharman Lamka, President, The FACES Foundation

Comments:

Registration is required. Space is limited.
* indicates required field.

PULMONARY ILLNESS: Trends & Treatment Series

REGISTRATION FORM