Advances in Diabetes and Thyroid Disease - HMS-CME

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Registration Information Inquiries By phone 617-384-8600, Monday–Friday, 10 AM to 4 PM (EDT) or by e-mail at hms-cme@hms.harvard.edu. Online Information To register or view activity information online, visit www.cme.hms.harvard.edu/courses/joslin. Disclosure Policy Harvard Medical School (HMS) adheres to all ACCME Essential Areas, Standards, and Policies. It is HMS’s policy that those who have influenced the content of a CME activity (e.g., planners, faculty, authors, reviewers and others) disclose all relevant financial relationships with commercial entities so that HMS may identify and resolve any conflicts of interest prior to the activity. These disclosures will be provided in the activity materials along with disclosure of any commercial support received for the activity. Additionally, faculty members have been instructed to disclose any limitations of data and unlabeled or investigational uses of products during their presentations. Refund Policy A handling fee of $60 is deducted for cancellation. Refund requests must be received by postal mail, e-mail, or fax one week prior to this activity. No refunds will be made thereafter. Course Location All sessions for this course will be held at the Fairmont Copley Plaza Hotel, 138 St. James Avenue, Boston, MA (Telephone: 1-800-441-1414 or 617-267-5300). Accommodations/Travel A limited number of rooms have been reserved at the Fairmont Copley Plaza Hotel (Telephone: 1-800-441-1414) until October 11, 2012. Please specify that you are enrolled in this course to receive a reduced room rate of $299 per night for Moderate and Fairmont Rooms (limited quantity) and $329 per night for Deluxe Rooms. Hotel arrangements can also be made online at https:/resweb.passkey.com/go/ joslindiabetes. Please do not purchase nonrefundable airline ticket(s) until you have received an e-mail from our office confirming your paid registration. For airline reservations contact the HMS Travel Desk toll-free 1-877-4-HARVMD (1-877-442-7863) Monday–Friday 9 AM–8 PM (EDT). From outside the U.S., Canada, and Virgin Islands, please call 617-559-3764. In compliance with the Americans with Disabilities Act, Harvard Medical School will make every reasonable effort to accommodate your needs during your attendance at this activity. For any special requests, please contact Joslin Diabetes Center at 888-567-5460. 6 Advances in Diabetes and Thyroid Disease 2012 Affiliated Performance Improvement CME (PI CME) through the Joslin Professional Education Continuum (JPEC) This activity is aligned with four PI CME Pathways available via JPEC at www.jpec.joslin.org. 1. Type 2 Diabetes Office Systems 2. Insulin Therapy 3. Advancing Therapies for Type 2 Diabetes 4. Cardiometabolic Risk Performance Improvement CME is a construct introduced by the AMA in 2004. Completion of PI CME stages can result in up to 20 AMA PRA Category 1 Credits. All four of the above pathways are approved through the American Board of Internal Medicine’s (ABIM) Approved Quality Improvement (AQI) Pathway and are eligible for 20 points towards the Self-Evaluation of Practice Performance requirement of Maintenance of Certification (MOC). For more information, go to www.abim.org/moc/. Visit www.jpec.joslin.org to get started. What your colleagues are saying about Advances in Diabetes and Thyroid Disease “This was one of the best conferences I have attended in my entire career. It was a realistic view of the diabetic patient as well as the thyroid patient. The speakers were very knowledgeable and able to articulate their knowledge well.” “It gave me some food for thought about a few difficult patients that I have not known how to follow. Thank you.” “Very helpful. I look forward to using the online resources as well.” “I love the practical approach and pearls.” “Providers are up to date and part of ongoing research on the topic. The case-based workshops on oral meds and insulin were especially helpful.”
Advances in Diabetes and Thyroid Disease 2012 November 1–3, 2012 Registration Form Registration Information Tuition Fee Through June 21 June 22–September 21 After September 21 Physicians $495 (USD) $595 (USD) $695 (USD) Residents, Fellows in Training, Allied Health Professionals $395 (USD) $495 (USD) $595 (USD) Nonclinical Industry Professional $795 (USD) $895 (USD) $995 (USD) Attendance is limited—register early and save up to $200! Registration by credit card (VISA or MasterCard) can be made at www.cme.hms.harvard.edu/courses/joslin. Registration by check (draft on a United States bank), please make payable to Harvard Medical School and mail with this page to Harvard Medical School– Department of Continuing Education, PO Box 417476, Boston, MA 02241-7476. Telephone or fax registration is not accepted. Registration with cash payment is not permitted. Upon receipt of your paid registration an e-mail confirmation from the HMS-DCE office will be sent to you. Be sure to include an e-mail address that you check frequently. Your e-mail address is used for critical information including registration confirmation, evaluation, and certificate. One registrant per form, please—you may photocopy the form for others. Print clearly—all fields required. Please check the type of registration: Physician Resident, Fellow in Training, Allied Health Professional Nonclinical Industry Professional $__________________ Full Name ____________________________________________________________________________________________________ Address ______________________________________________________________________________________________________ City ______________________________________________________State ________ Zip Code _______________________________ Country ______________________________________________________________________________________________________ Daytime Phone ______________________________________________ Fax Number _______________________________________ Please note: Your e-mail address is used for critical information about the course including registration confirmation, evaluation, and certificate. Please be sure to include an e-mail address you check daily or frequently. E-Mail Address ________________________________________________________________________________________________ Please check if you wish to be excluded from e-mail notices of future Harvard Medical School – Department of Continuing Education programs. Profession _______________________________________________________ Degree ______________________________________ Primary Specialty (Physicians only) _______________________________________________________ Board Certified: Yes No Professional School Attended (Physicians only) Harvard Medical School U.S. Medical School International Year of Graduation _________________________________ 7
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Page 5: Aaron M. Cypess, MD, PhD, MMSc Assi

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