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E E R I 5-6 MAY 2018 | MAJORCA, SPAIN V C O E N S TI O N
SIS INTERNATIONAL OUTREACH COURSE HANDS-ON LEARNING FOR REGIONS WITH LIMITED SPINE INTERVENTION TRAINING OPPORTUNITIES
COURSE DETAILS WHO MAY ATTEND With this international outreach course, SIS is bringing Registration is limited to: hands-on lumbar intervention training to Majorca, Spain exclusively to SIS members based in Europe. • SIS Fellow and Resident Members Residing in Europe You will experience 8 hours of hands-on lab instruction • SIS International Members Residing in Europe Who with phantom spine models and 5.75 hours of lectures, Are Within Their First 5 Years of Practice breakout sessions, and discussions with your instructors. International Members not meeting the above criteria The techniques you will learn and practice at this course may submit registration and will be placed on a wait list. will provide your foundation for achieving optimal Payment will not be processed unless you have obtained patient outcomes. a spot. HANDS-ON LAB TRAINING NOT AN SIS MEMBER YET? • Needlecraft Join at SpineIntervention.org/apply. Spine • Interlaminar Epidural Intervention Society membership is available to • L1-5 Transforaminal Epidural (subpedicular) physicians and medical students worldwide. Members • Medial Branch Block must be board-certified or pursuing certification in • S1 Transforaminal Epidural Anesthesiology, Physical Medicine and Rehabilitation, • Sacroiliac Joint Radiology, Neurology, Orthopedic Surgery, or Neurosurgery—or demonstrate comparable LECTURES AND BREAKOUTS qualifications in their country of residence. Membership • Anatomy and Imaging is complimentary for Medical Students, Residents, and • Indications and Techniques Fellows. • Risks and Complications • Complications and Management CONTINUING MEDICAL EDUCATION (CME) The Spine Intervention Society (SIS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. SIS designates this live activity for a maximum of 13.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
SPINE
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E E R I 5-6 MAY 2018 | MAJORCA, SPAIN V C O E N S TI O N
YOUR ON-SITE SIS CONTACTS IN-KIND COMMERCIAL SUPPORT Ine Wiegerink / Irma Spanjer, [email protected], DISPOSABLE SUPPLIES PROVIDED BY: +31.743.76.2014. Halyard Health FOR FURTHER INFORMATION COMMERCIAL SUPPORT DISCLOSURE Katrina Pierce, [email protected]. The Society fully complies with all ACCME requirements LAB FACILITY for commercial support and maintains a separation of promotion from education. The content or format Hospital de Inca Carretera Vella de Llubí, s/n of SIS CME activities and related materials promote 07300 Inca improvements or quality in healthcare and not a specific Balearic Islands, Spain proprietary business interest of a commercial interest. The Spine Intervention Society is a non-profit medical HOTEL AND TRANSPORTATION society. Revenues from all courses are used to further the Attendees must make their own hotel and travel Society’s mission. arrangements. Majorca is served by Palma de Mallorca . COURSE MATERIALS Airport (PMI) Materials presented at this course are made available by SIS will provide transportation from and to the Colegio the Spine Intervention Society for educational purposes Oficial de Médicos de Islas Baleares at Paseo de only. No distribution or reproductions of any kind, Mallorca, 42, 07012 in Palma at the times specified in the including audio and video recordings, may be made of agenda. the presentations. SIS reserves all rights to such material. ATTENDEE PREPARATION Prior to attendance, participants are encouraged to familiarize themselves with Spine Intervention Society- sanctioned materials that will be emailed to registrants at least one week prior to the course and SIS’s Practice Guidelines for Spinal Diagnostics and Treatment Procedures, 2nd Edition. Attendees will receive digital copies of the presented lectures upon completion of the course.
Get your copy of SIS’s Practice Guidelines for Spinal Diagnostics and Treatment Procedures, 2nd Edition.
Visit SpineIntervention.org or call 630.203.2252 to order.
Centrally situated on Majorca, Palma and the town of Inca provide the perfect launching points to explore all the natural beauty and historic significance of this Mediterranean island destination.
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THE SPINE INTERVENTION SOCIETY WAS FORMERLY KNOWN AS
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E E R I V C E O FOLLOW SIS ON FACEBOOK, LINKEDIN, N S TI O N AND ON TWITTER @SPINESOCIETY. THE WORLD'S PREMIER SOURCE OF SPINE INTERVENTION EDUCATION
SUBMIT YOUR COMPLETED REGISTRATION FORM TO [email protected]
SPINE
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E E R I 5-6 MAY 2018 | MAJORCA, SPAIN V C O E N S TI O N
AGENDA SATURDAY 5 MAY Course Venue Hospital de Inca 7:30 Shuttle to Hospital de Inca from Colegio Oficial de Médicos de Islas Baleares 8:00 Registration / Morning Coffee 8:30 LECTURE: ANATOMY AND IMAGING 9:30 LECTURE: INDICATIONS AND TECHNIQUES 10:30 HANDS-ON LAB: NEEDLECRAFT 11:30 HANDS-ON LAB / BREAKOUT: 70-MINUTE ROTATION 12:40 Lunch 13:20 HANDS-ON LAB / BREAKOUT: 70-MINUTE ROTATIONS 15:40 Break 15:55 HANDS-ON LAB / BREAKOUT: 70-MINUTE ROTATIONS 18:15 Adjourn for the Day 18:20 Shuttle from Hospital de Inca to Colegio Oficial de Médicos de Islas Baleares
SUNDAY 6 MAY 7:30 Shuttle to Hospital de Inca from Colegio Oficial de Médicos de Islas Baleares 8:00 Morning Coffee 8:30 LECTURE: RISKS AND COMPLICATIONS 9:30 HANDS-ON LAB / BREAKOUT: 70-MINUTE ROTATIONS 13:00 DISCUSSION 13:30 Course Adjourns 13:40 Shuttle from Hospital de Inca to Colegio Oficial de Médicos de Islas Baleares
THE SPINE INTERVENTION SOCIETY THANKS OUR VOLUNTEER INSTRUCTORS
Brad GOODMAN, MD Marcello G. MELI, MD Miguel TEJERO GARCIA, MD Physiatry Anesthesiology Anesthesiology Birmingham, Alabama, U.S.A. Palma, Majorca, Spain Palma, Majorca, Spain
Stephan KLESSINGER, MD Michiel SCHEPERS, MD Neurosurgery Musculoskeletal Medicine Mittelbiberach, Biberach, Germany Delden, Overijssel, Netherlands
SUBMIT YOUR COMPLETED REGISTRATION FORM TO [email protected]
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E E R I 5-6 MAY 2018 | MAJORCA, SPAIN V C O E N S TI O N REGISTRATION RATES SIS International Physician Member (In first 5 years of practice) - $590 U.S. Dollars ONLINE REGISTRATION IS NOT AVAILABLE SIS Fellow/Resident Member (Residing in Europe) - $325 U.S. Dollars COMPLETE THIS FORM AND RETURN WITH PAYMENT VIA REGISTRATION INFORMATION EMAIL, FAX, OR MAIL: Registration is required and accepted on a first-come, first-served basis. Registrants will be confirmed via email. If you do not receive a confirmation, please contact EMAIL [email protected] [email protected]. Do not book hotel accommodations or airfare until you are confirmed for the course.Registration will not be processed FAX +1.415.457.3495 without payment.
MAIL Spine Intervention Society CANCELLATION POLICY 120 E. Ogden Avenue, Suite 202 Cancellations must be requested within 21 days prior to the course for a refund less Hinsdale, Illinois 60521-3546 U.S.A. a $150 administrative fee. Cancellations made less than 21 days prior will result in forfeiture of all fees. SIS reserves the right to cancel this event due to circumstances beyond its control. The Society assumes no financial obligation to registrants for costs incurred.
ATTENDEE INFORMATION PAYMENT AND ACKNOWLEDGMENT:
FIRST / LAST NAME / SUFFIX AMEX / MC / VISA / DISCOVER
EXP DATE / SECURITY CODE
BUSINESS ADDRESS EMAIL COPY OF RECEIPT TO
BEST NUMBER TO CONTACT YOU DURING EVENT YES
I HAVE READ AND AGREE TO THE PHOTOGRAPHY DISCLAIMER EMAIL YES
FOR GROUPING PURPOSES, # OF YEARS PRACTICING SPINE INTERVENTIONS I HAVE READ AND AGREE TO THE CODE OF CONDUCT
EMERGENCY CONTACT NAME/NUMBER/RELATIONSHIP SIGNATURE SIS EMAIL SIS WEBSITE SIS BROCHURE GOOGLE SEARCH CODE OF CONDUCT FACEBOOK/LINKEDIN/TWITTER POSTING SIS has a zero-tolerance policy for any form of discrimination or harassment, including, but not limited to, offensive verbal or written comments related to race, color, creed, religion, national origin, gender, age, disability, marital status, sexual WHAT PROMPTED YOU TO REGISTER TODAY? orientation, military status, gender identity, or gender expression; the display of sexual images in public spaces; deliberate intimidation, stalking, or following; harassing photography or recordings; sustained disruption of talks or other events; inappropriate physical contact; and unwelcome sexual attention. PHOTOGRAPHY DISCLAIMER I agree to hold harmless and indemnify the Society from any and all claims All attendees, speakers, sponsors, staff, and volunteers at Society activities are involving the use of my picture or likeness. The Society reserves the right to use required to agree to uphold this code of conduct during the event and in activity- any photographs or videos taken at SIS events without the expressed written related social events at off-site locations and in related online communities and permission of those included within. The Society may record your likeness, image, social media. voice, sound effects, interview, and performance and edit and incorporate such recording into formats including, but not limited to, educational, literary, and/or If you experience harassment or hear of any incidents of unacceptable behavior, promotional materials such as advertising, website, and social media content with SIS asks that you inform either Margaret Klys, MJ, CAE, Executive Director/CEO, at or without the participant’s name. [email protected] or +1.708.505.9416 or Anne Rounds, CMP, HMCC, Director of Meetings, at [email protected] or +1.415.385.7462. SIS shall retain final editorial, artistic, and technical control of the recording and content from any event and may use and authorize others to use the recording Those who violate this Code of Conduct will be asked to cease any inappropriate and any portions thereof in all markets, manner, and media, whether now known or behavior, are expected to comply immediately, and may be subject to sanctions hereafter developed. SIS and/or its successors and assignees shall own all rights, up to and including expulsion from the activity without refund and prohibition from title, and interest, including the copyright, in and to the recording and related attendance at future Society activities. materials to be used and disposed of without limitation, as SIS shall determine.