<p> Department of Professional Education Behavioral Health Issues and Therapies: Stayin' Alive with Meds, Music, Art and Animals Wednesday, September 22, 2010 Crowne Plaza Anaheim 12021 Harbor Blvd, Garden Grove, Ca Self-parking is free Registration/Continental Breakfast/Exhibitor Viewing: 7:15am - 7:50am Program: 8:00am – 3:45pm TOPICS & SPEAKERS: Depression and Anxiety Update# Michael Hanna, PhD, Kaiser Permanente, Fontana Medication Treatment Update for Depression and Anxiety# Betty Haller, PharmD Suicide Prevention# Veronica Scarpelli, American Foundation for Suicide Prevention, Greater Los Angeles Music and Art Therapies Lisa Lynne, Founder of “Hands-On-Harps” interactive music program Erica Curtis, MFT, ATR-BC, Registered Board Certified Art Therapist Animal Therapy: Dogs at Work Dondi Austin, CNM, Kaiser Permanente, Downey</p><p>REGISTRATION FEES (Includes continental breakfast, lunch and CEUs) Website: http://www.kpsymposia.com $75.00 fee on the website by September 9th @ 9pm $100.00 fee on the website between Sept. 9th @ 9:01pm – Sept. 16th @ 9:00pm </p><p>Mail: $85.00 if registration is postmarked by September 9th $110.00 if registration is postmarked between Sept. 10th and Sept. 15th Do not mail a registration after Sept 15th. Register on the website or onsite. Onsite: $125.00 </p><p>Refunds will be granted until Sept. 15; no refunds after that date. Check payment will be refunded (less the $10 processing fee) in the form of a voucher for another symposium. Website registrations will be refunded to the credit card. E-mail [email protected] to request a refund. If symposium is canceled, the above refund policy will be enforced. Kaiser Permanente Professional Education (626) 564-3082, tie 338 Course Description: Course is designed to provide updates on health care issues relevant to clinical practice and investigate aspects of other related disciplines that enhance the understanding or practice of social work.</p><p>Continuing Education Credits Nurses: Provider approved by the California Board of Registered Nursing, Provider Number CEP751 for 7 contact hours. Certified Nurse-Midwives: ACNM specialty credit will be applied for. Physician Assistants : This program is not yet approved for CME credit. Conference organizers plan to request 6 hours of AAPA Category I CME credit from the Physician Assistant Review Panel. Total # of approved credits yet to be determined. LCSWs & MFTs: Course meets the qualifications for 6 hours of continuing education credit for LCSWs and MFTs as required by the California Board of Behavioral Sciences. Provider #PCE 1763. Professional Education Behavioral Health Issues and Therapies: Stayin' Alive with Meds, Music, Art and Animals Wednesday, September 22, 2010 Crowne Plaza Anaheim All the requested information below is required; please fill the form out completely. REGISTRATION INFORMATION: Registrations by mail must be accompanied by payment. Registration via mail is an additional $10 for processing. See previous page for exact amount. No fax registrations accepted  We discourage sending a registration via interoffice mail. Please make checks payable to Kaiser Permanente US Mail: KP Professional Education, 100 S. Los Robles Ave, #501, Pasadena, CA 91101 If registration fee is not received by September 20th, payment required on-site. Please see previous page for refund policy.</p><p>FIRST & LAST NAME</p><p>Home address</p><p>City, State & Zip</p><p>E-Mail Address A valid e-mail address is required to receive the registration confirmation/receipt, link to handouts & evaluation License # Daytime Phone # Facility name Department</p><p>Employer:  Kaiser Permanente  Community Colleague/Non-KP</p><p>Check your license type: CNM NP PA RN  Other ______</p><p>Lunch Choice  Chicken Entrée  Vegetarian Entrée </p><p>CREDIT CARD FORM ONLY Amex, Visa, MasterCard accepted</p><p>Credit Card # Amount to Charge $ Expiration Date (determined by postmark date) Name on Credit Card (please print)</p><p>Cardholder signature</p>