2019 OHSU CME Livecast Event Registration

 

Skip the drive! Pediatric and Adult Mental Health Conferences will be Livecast to Eastern Oregon University in La Grande!

 

Pre-Register by Friday, March 1st.

 

Two Webcast Events:

 

Friday, March 8th--2nd Anual Pediatric Mental Health Webcast: Equipping the Primary Care Provider

7:50 A.M.-4:45 P.M.

 

 

This continuing medical education activity focuses on the reality that many pediatric mental health issues are managed by general pediatricians, family physicians, and others that provide primary care for children and adolescent. Difficulty in accessing mental health specialty care has led to an increase in psychiatric treatment in the offices of primary care providers.

 

Friday, March 15th--3rd Annual Adult Mental Health Update: Strategies for Primary Care

7:50 A.M.-4:45 P.M.

 

 

Difficulty accessing mental health specialty care has led to an increase in psychiatric diagnosis and treatment in the primary care clinic. The goal of this conference is to better equip the primary care provider at delivering effective mental health care to their patients.

 

Please select which event(s) you would like to register for below.

 

Note that each CME participant must register separately.

Quantity
Price
Total
March 8, 2019 CME Event Ticket

Friday, March 8th--2nd Annual Pediatric Mental Health Webcast: Equipping the Primary Care Provider Webcast 7:50 A.M.-4:45 P.M. Eastern Oregon University/OHSU School of Nursing Campus

X
$
25.00=
$
0

March 15, 2019 CME Event Ticket

Friday, March 15th--3rd Annual Adult Mental Health Update: Strategies for Primary Care 7:50 A.M.-4:45 P.M. Eastern Oregon University/OHSU School of Nursing Campus

X
$
25.00=
$
0

Final Total:
$
0

Name and Position

Position/Job Title*
Organization Name*
Professional Degree (Example: MD, DMD, MAT, etc.)*

***Cardholder Address***

 

This MUST be the billing address for the card information provided at the bottom of this form.

Country*
State / Province*
Address*
City*
*
*
*
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Email Address*
Confirm Email*
Phone Number*

Background Information

Birthdate (mm/dd/yyyy)*
County*
Do you have any food allergies or special needs that we can accomodate? If yes, please describe below.

Photograph and Background Information Release

By typing my name below, I authorize Northeast Oregon Area health Education Center (NEOAHEC) and those acting under its permission or authority, to use and publish any photographs or video footage in which I may be included in whole or in part during this event.

 

NEOAHEC may also use background information from my application or other information collected at this event for marketing and reporting purposes. I waive any right that I may have to approve the finished product or copy or the use to which it may be applied.

 

By typing my name below, I release and discharge NEOAHEC and those acting under its permission or authority from any liability for the use of any video footage or photo of me.

Signature*
Date (mm/dd/yyyy)*

Participant Release

In consideration of being permitted to attend and participate in this CME event, the undersigned hereby releases, waives, discharges, and covenants not to sue all persons affiliated in any way with Northeast Oregon Area Health Education Center (NEOAHEC)(hereinafter called “Releasees”), including but not limited to its employees, counselors, officers, advisors, and administrators, for and from all claims and/or all liability to the undersigned and their personal representatives, assigns, heirs and next of kin for all loss or damage and any claim or damage therefore on account of injury or death to the undersigned or any injury or destruction of property, whether caused by the negligence of Releasees or otherwise while said applicant is for any purpose participating in said Program or any related activity. Furthermore, the undersigned agrees to hold Releasee harmless from all claims, suits, actions, or judgments asserted or brought on account of or related to the applicant’s participation in the above mentioned activities.

 

The undersigned expressly agrees that this release, waiver and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the state of Oregon and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. We further release all of said Releasees from any claim whatsoever on account of first aid, treatment or service rendered to the applicant during the applicant’s participation in the above mentioned activities and hereby consent to the rendering of such medical treatment, as Releasees shall deem appropriate.


By signing below, I am signifying that I have read and signed the above authorizations and releases: (1) Photograph/Background Information Release (2) Participant Release and am fully familiar and in agreement with the contents thereof.

Signature*
Date (mm/dd/yyyy)*
Click here to verify that you have reviewed this form for accuracy.*
  • Yes. I certify that I have reviewed this form and all of my information is correct

Registration Fee

A $25 registration fee is required for each CME event. This fee includes a light breakfast, lunch, and instructional materials.

Payment Information

Amount*
$
Name on Card*
Card Number*
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