2014 AKOMA ACP brochure FINAL · data quality reviews. Ms. Kuehn has authored multiple books for...

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Photo of the APU Nordic Ski Team training at Hatcher Pass, courtesy of Sarah Cresap Early Bird rates before April 1st. No pre-registrations accepted after Friday, May 1, 2014. e American College of Physicians is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. e American College of Physicians designates this live activity for a maximum of 20 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. AKOMA has requested that the AOA Council on Continuing Medical Education approve this program for 19 credits of AOA Category 1-A CME credits. Approval is currently pending. C M E MEETING 2014 Millennium Hotel, Anchorage MAY 8–10 Alaska Chapter American College of Physicians and Alaska Osteopathic Medical Association

Transcript of 2014 AKOMA ACP brochure FINAL · data quality reviews. Ms. Kuehn has authored multiple books for...

Page 1: 2014 AKOMA ACP brochure FINAL · data quality reviews. Ms. Kuehn has authored multiple books for both the American Health Information Management Association (AHIMA) and the Medical

Photo of the APU Nordic Ski Team training at Hatcher Pass, courtesy of Sarah Cresap

Early Bird rates before April 1st. No pre-registrations accepted after Friday, May 1, 2014.

�e American College of Physicians is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

�e American College of Physicians designates this live activity for a maximum of 20 AMA PRA Category 1 Credit(s)™.Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AKOMA has requested that the AOA Council on Continuing Medical Education approve this program for19 credits of AOA Category 1-A CME credits. Approval is currently pending.

C M EMEETING

2014Millennium Hotel, Anchorage

MAY 8–10

Alaska Chapter American College of Physicians andAlaska Osteopathic Medical Association

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US Equipment Introduction

Central Line Placement-- break --

Abdominal U/S w/Procedures

Thoracic U/S-- break --

DVT Assessment

Hands-on US TrainingUAA Health Sciences, Rm.206

Amy Morris, MD, and team

1:30

ECG CasesLisa Gray, DO

MEETING ADJOURNED

DINNER: In Celebration of Medicine & SportLarry Gaul, MD, US Nordic Ski Team Physician;

Erik Flora, Director - APU Nordic Ski Center and Elite Nordic Ski Athletes

4:30

5:30

6:30

Registration/BREAKFAST

Welcome - Molly Southworth, MD, Governor

Recent Developments in Hospital MedicineMark Zaros, MD

BREAK: Please visit exhibit hall

Introduction to Bedside UltrasoundAmy Morris, MD

LUNCH PROVIDED

High Value CareSusan Thompson-Hingle, MD

Management of Type 2 DiabetesAnne Peters, MD

BREAK: Please visit exhibit hall

ID Cases 2014Thomas Moore, MD

7:30

8:25

8:30

10:30

11:00

Noon

1:00

2:00

3:00

3:30

ACP Advancement to FellowshipMolly Southworth, MD, Governor

Easy OMT for the Dirty Half-DozenAl Turner, DO

FRIDAY

Registration Open

WelcomeMolly Southworth, MD, AK ACP Governor

Mark Tucillo, DO, AKOMA President

ID Update 2013Thomas Moore, MD

Help, Doc - I’m SickMoe Hagman, MD

BREAK: Please visit exhibit hall

Medical & Surgical Management of Skin CancerScott Drew, DO

Hands On or Hands O� - Common Hand Problems in Primary CareCandy Clawson, DO

Wine & Cheese Social

ACP Council Meeting

12:30

12:55

1:00

2:00

3:00

3:30

4:30

5:30

7:00

Dermatology UpdateScott Drew, DO

THURSDAY

Breakout Sessions

REDINGTON L AKE SPENARD OFFSITE

AKOMA Board Meeting

NO

TE: Program details are subject to change.

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7:30

8:00

8:30

9:00

10:00

10:30

11:30

12:30

1:30

2:30

3:30

4:00

5:00

6:00

BREAKFAST

Exercise at High Altitude: What to Expect/How to SurviveLarry Gaul, MD

The Doping Mess: What the Local Doc Needs to KnowLarry Gaul, MD

Diabetes and SportAnne Peters, MD

BREAK: Please visit exhibit hall

Best Practices in Pre-participation Screening for AthletesChristine Lawless, MD, FACC, FACSM

Cardiac Problems in Endurance AthletesChristine Lawless, MD, FACC, FACSM

LUNCH PROVIDEDACP Town Hall Meeting:

Fostering Excellence in Internal Medicine

ICD 10: What Providers Need to Know Lynn Kuehn

Appropriate Opioid Prescribing in Primary Care PracticeNicolas Wieder, DO

BREAK: Please visit exhibit hall

EHR LiabilityJosh Hyatt

Doctors Dilemma (Jeopardy)Moe Hagman, MD

MEETING ADJOURNED

AKOMA Membership Meeting

SATURDAY

Volume Status Assessment

US Q&A @ station of choice

ACP Smart Medicine: A Point-of-Care, Electronic Information ToolSusan Thompson-Hingle, MD

ECG CasesLisa Gray, DO

MEETING ADJOURNED

DINNER: In Celebration of Medicine & SportLarry Gaul, MD, US Nordic Ski Team Physician;

Erik Flora, Director - APU Nordic Ski Center and Elite Nordic Ski Athletes

4:30

5:30

6:30

Registration/BREAKFAST

Welcome - Molly Southworth, MD, Governor

Recent Developments in Hospital MedicineMark Zaros, MD

BREAK: Please visit exhibit hall

Introduction to Bedside UltrasoundAmy Morris, MD

LUNCH PROVIDED

High Value CareSusan Thompson-Hingle, MD

Management of Type 2 DiabetesAnne Peters, MD

BREAK: Please visit exhibit hall

ID Cases 2014Thomas Moore, MD

7:30

8:25

8:30

10:30

11:00

Noon

1:00

2:00

3:00

3:30

NO

TE: Program details are subject to change.

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REGISTER ONLINE: (ACP members only) Register at

REGISTER BY MAIL: To register by mail, complete the registration form and mail it to ACP at the address below. Be sure to list your daytime phone number in case we need to notify you of any changes. Please reproduce the form for additional registrations (one form per registrant).

AC002American College of Physicians190 N. Independence Mall West

Philadelphia, PA 19106-1572

REGISTER BY FAX: Register 24 hours a day via fax at (215) 351-2799. Fax forms must include credit card number, expiration date, security code number, and signature. Do not mail a copy of the form because it may result in a duplicate registration and you will be charged twice.

REGISTER BY PHONE: Call (800) 523-1546, ext. 2600, or (215) 351-2600 (M-F, 9 a.m.–5 p.m. ET). Be sure to have your credit card number, expiration date, and security code number available before calling.

PAYMENT OPTIONS: Payment in full is required. Make check or money order payable to ACP. Must remit in U.S. funds drawn on a U.S. bank. If paying by credit card, please provide the credit card number, expiration date, security code, and authorizing signature.

ADDITIONAL FEES: All registrations must be received by April 1, 2014 or a late registration fee of $100 will be added. This includes on-site registrations. Save money by registering now!

CANCELLATIONS/REFUNDS: All cancellation requests must be received by Member and Customer Service in writing (e-mail [email protected]). Cancellations will not be accepted by telephone.

SATISFACTION GUARANTEE: We o�er a satisfaction guarantee—if meeting attendees are not satis�ed with their experience at the meeting, they may write for a refund of their registration fee.

SPECIAL NEEDS: If you have a disability or any special dietary needs, please contact Julie Lake by telephone at 907-350-2351 or e-mail [email protected].

HOTEL: Millennium Hotel has a limited number of rooms available at the AK ACP/AKOMA group rate. Please call (907) 243-2300. The group rate is $85 per night.

QUESTIONS?For registration information, contact ACP Member and Customer Service (M-F, 9 a.m.–5 p.m. ET) toll-free at (800) 523-1546, ext. 2600 or direct at (215) 351-2600. You may also e-mail [email protected] or fax (215) 351-2799. You can also contact Marcia Batchelder, AKOMA A�liate Director at 800-617-5310 or [email protected].

If you need more information on the meeting schedule or location, please contact:

AK ACP Julie Lake , tel. (907) 350-2351 or email [email protected] AKOMA Marcia Batchelder, tel. (800) 617-5310 or [email protected]

http://www.acponline.org/about_acp/chapters/ak/news_meet.htm

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Erik Flora

Erik was born in Oregon and has pursued a life of ski racing. As an athlete, he represented the United States at World Junior Championships, was an NCAA All-American, and won the Tour of Anchorage three times. As a coach, Erik has been the recipient of the USSA cross-country domestic coach of the year, cross country international coach of the year, and development coach of the year awards while directing APU to two USSA Cross Country Ski Club of the Year awards. Erik coached APU/US Ski Team athlete Kikkan Randall to the �rst female World Cup Gold Medal and the �rst World Championship Silver Medal to make US Skiing History. Most recently, Erik coached 4 APU/US Ski team athletes that made the 2014 Winter Olympics! When he isn’t coaching, Erik loves to spend time with his wife, Gretchen, and their three young children. Erik has been the Alaska Paci�c University Nordic Ski Center program director and head coach for the past seven years.

G. Scott Drew, DO, FAOCD

Dr. Drew practices in the Department of Dermatology at Smith Clinic in Marion, Ohio. He is the past Director of the Ohio University/O’Bleness Memorial Hospital Dermatology Residency Program and an Adjunct Clinical Faulty member at the Ohio State University College of Medicine and Public Health and Associate Professor at Marian University College of Osteopathic Medicine. Dr. Drew is a graduate of the Kirksville College of Osteopathic Medicine. He completed his internship at Normandy Hospital in St. Louis, his residency at the University of Medicine and Dentistry of New Jersey and his Fellowship at the Deaconess Hospitals North in St. Louis. Dr. Drew is Board Certi�ed by the America Osteopathic Board of Dermatology and the American Osteopathic College of General Practice.

Candace Clawson, DO

Dr. Clawson is a Senior Orthopedic Surgeon, Hand Surgery specialist with the Alaska Native Medical Center. She is Board Certi�ed in Orthopedic Surgery and has a Certi�cate of Advanced Quali�cation (CAQ) in Hand/Wrist Surgery. Dr. Clawson graduated from the Kirksville College of Osteopathic Medicine in Kirksville, MO. She completed her Orthopedic Surgery Residency at the Garden City Osteopathic Hospital in Michigan and went on to complete a Fellowship in Hand and Microsurgery at the Detroit Medical Center. Dr. Clawson also has a Medical Acupuncture for Physicians Certi�cate from the University of Southern California.

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Melissa (Moe) Hagman, MD, FACP

Dr. Hagman is an Associate Professor at the University of Washington Department of Medicine. She is also the Associate Program Director of the Boise Internal Medicine Residency Program. Dr. Hagman is a graduate of the University of Washington, School of Medicine. She completed her Internship, Residency, and Chief Residency in Internal Medicine, Primary Care Track at the University of Washington A�liated Hospitals, Seattle, WA and Boise, ID. Dr. Hagman has several honors including: University of Washington Dr. Paul Beeson Award, 2006, Top Doctor, Seattle Magazine, 2008-2009, Richard M. Tucker Regional Internal Medicine Faculty Excellence in Teaching Award, 2013, Society of General Internal Medicine Northwest Regional President, 2013 and Richard M. Tucker Regional Internal Medicine Faculty Excellence in Teaching Award, 2013.

Lisa Gray, DO

Dr. Gray is a Cardiologist practicing at the Alaska Heart Institute in Anchorage. Dr. Gray is board-certi�ed and a member of the American Board of Internal Medicine (Sub: Cardiovascular Disease). Dr. Gray earned a Fellowship at Lankenau Hospital, completed Residency at Lehigh Valley Hospital, and attended Medical School at Philadelphia College of Osteopathic Medicine. Dr. Gray has received several awards including the 2003 John J. Kelly, MD Cardiology Fellowship Award from the Lankenau Hospital in Wynnewood, Pennsylvania, the 2001 Physician Recognition Award from St. Luke’s Hospital in Allentown, Pennsylvania, and the 2000 Stephen A. Renner, DO, Excellence in Cardiology Award from the Lehigh Valley Hospital.

Lawrence W. Gaul, MD, FACC

Dr. Gaul is the Vail Valley Medical Center Medical Director ICU. He also practices Cardiology at Avanti Cardiology in Vail, CO. He is a graduate of the University of Colorado School of Medicine. He completed his Internal Medicine residency at the Mary Imogene Bassett Hospital in Cooperstown, NY and earned his Cardiovascular Diseases Fellowship from the Milton S. Hershey Medical Center. Dr. Gaul is a member of the United States Ski and Snowboard Association. As a member he serves as the U.S. representative to the International Ski Federation (FIS) since 2005. He is the Team Physician for Nordic Disciplines, the Traveling Physician for Cross Country, and the Cardiovascular Disease Consultant. His personal interests include endurance sports and performance.

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Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA

Lynn Kuehn is a health care consultant with over twenty-�ve years of experience, including operational assessment, professional fee coding and reimbursement system education, and data quality reviews. Ms. Kuehn has authored multiple books for both the American Health Information Management Association (AHIMA) and the Medical Group Management Association (MGMA) and is an AHIMA-approved ICD-10-CM and PCS Trainer. She is a Registered Health Information Administrator, a Certi�ed Coding Specialist for Physicians, and a Fellow of AHIMA.

Josh Hyatt

Josh has had a varied career in healthcare, including inpatient psychiatric, administrative, regulatory, compliance and risk management. He currently works as a Senior Risk Manage-ment Specialist with a national malpractice insurance carrier, specializing in risk mitigation, ethics consultation, and provider education. In addition, he is an Adjunct Professor teaching medical ethics, health law, leadership in healthcare, and healthcare administration and policy. His previous employment includes private healthcare consultant, Vice President of Regula-tion and Accreditation in a hospital setting, and 5 years working at the State of Florida and federal government assessing compliance with Medicare and Medicaid requirements and combating healthcare fraud and abuse. He holds an undergraduate degree in Psychology, a graduate degree in Health Law and is currently a doctoral candidate in health science, specializing in medical law and bioethics. He is also nationally recognized through the American Hospital Association and ASHRM as a Certi�ed Professional in Healthcare Risk

Management (CPHRM).

Susan Thompson Hingle, MD, FACP

Dr. Hingle has been named Chair of the Board of Governors of the American College of Physicians (ACP), the nation’s largest medical specialty organization. Dr. Hingle’s new term began during Internal Medicine 2013, ACP’s annual scienti�c meeting in San Francisco, CA. Dr. Hingle has been a Fellow of the American College of Physicians (FACP) since 2001. In 2006, Dr. Hingle was honored with ACP’s prestigious Walter J. McDonald Award for Young Physicians. Additionally, in 2011, 2012, and 2013 she was awarded the John Tooker Evergreen Award for Chapter Management and Innovation. Dr. Hingle served as Governor of ACP’s Illinois Downstate Chapter between 2009-2013. Dr. Hingle has served on the ACP Board of regents, the ACP Executive Committee, the ACP Chapters Subcommittee, the ACP Women’s Task Force and the ACP Volunteerism Subcommittee. Board-certi�ed in internal medicine, Dr. Hingle is a general internist, a Professor of Clinical Medicine at the Southern Illinois University School of Medicine. She is serving as Interim Chair of the Department of

Medicine as well as Clerkship Director, Associate Residency Program Director and Associate Doctoring Curriculum Director. She earned a bachelor’s degree from Miami University and a medical degree from Rush University Medical College. She completed an internal medicine residency at Georgetown University Medical Center, where she served as Chief Resident of Internal Medicine.

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Amy Morris, MD

Dr. Morris is Assistant Professor of Pulmonary and Critical Care Medicine at the University of Washington. She was raised in Anchorage, attended medical school through the WWAMI program, and completed her clinical training at the University of Washington before joining the faculty in 2009. She attends on the medical ICU and pulmonary consult services at UW Medical Center and is a clinician educator. She is a core faculty member of the UW Institute for Simulation and Interdisciplinary Studies (ISIS), where she leads multidisciplinary curricu-lum development e�orts in these areas. She is also a member of the Innovation Task Force of the American Registry for Diagnostic Medical Sonography (ARDMS), charged with developing national assessment tools for point of care ultrasound, and the Simulation Work Group of the American College of Chest Physicians.

Thomas A. Moore, MD, FACP, FIDSA

Dr. Moore is Clinical Professor of Medicine at the University of Kansas School of Medicine in Wichita, KS. A graduate of Washington University in St. Louis and the University of Kansas School of Medicine, Dr. Moore completed his residency in internal medicine at Baylor College of Medicine in Houston, serving as Chief Resident at The Methodist Hospital. Subspecialty training in infectious diseases was completed at the National Institutes of Health (NIH) in Bethesda, Maryland. Dr. Moore served as Chair of the Department of Infectious Diseases at Ochsner Medical Systems, New Orleans, LA, 2010-2012, and as Chair of the Anti-Infective Drug Advisory Committee for the FDA 2008-2012 before returning to his home state of Kansas. In addition to clinical duties, Dr. Moore is actively engaged in research and education, authoring numerous papers and textbook chapters, and he has received teaching awards from students and residents, and peer recognition for service to his community. Dr. Moore has been a principal investigator for international research projects involving strongyloidiasis

and national trials evaluating treatments for West Nile Virus.

Christine Lawless, MD, MBA, ABCL, FACC, FACSM

Dr. Lawless is the only physician in the United States to be dual certi�ed in cardiology and sports medicine. Dr. Lawless has her own practice and consulting business in Sports Cardiol-ogy. She also serves as team physician to the United States Figure Skating World Teams, Former chair of US Figure Skating Sports Medicine Committee, and consulting cardiologist to Major League Soccer. She has published extensively in peer reviewed journals including the New England Journal of Medicine, the Journal of the American College of Cardiology, and the Journal of the American College of Sports Medicine, and she serves on the editorial board of Medical Sciences in Sports and Exercise, JACC, and The Physician and Sports Medicine. Dr. Lawless is a graduate of Loyola University Stritch School of Medicine. She completed her residency and Cardiology Fellowship at Loyola University Medical Center, Sports Medicine Fellowship at Lutheran General Hospital, and executive MBA at the University of Notre Dame.

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Mark Tuccillo, DO

Dr. Tucillo is the President of the Alaska Osteopathic Medical Association. He is a board certi�ed Osteopathic family practice physician. He received his medical training at the University of Medicine and Dentistry of the New Jersey School of Osteopathic Medicine in Stratford, NJ and completed his residency at Doctors Hospital in Columbus Ohio. He also has certi�cates of added quali�cation in sports medicine, Military Flight Surgeon, FAA Medical Examiner, and Dive Medical O�cer. Dr. Tuccillo practices rural family medicine in Petersburg, AK.

Molly Southworth, MD, MPH, FACP, FACE

Dr. Southworth is Governor of the Alaska Chapter of the American College of Physicians and Chief of Internal Medicine at Alaska Native Medical Center. She is board certi�ed in Endocrinology, Metabolism, and Nutrition, and practices Endocrinology at Alaska Native Medical Center. She is Clinical Associate Professor of Internal Medicine at the University of Washington School of Medicine and A�liate Associate Professor of Biomedical Science in the University of Alaska Anchorage/ WWAMI. A graduate of Oberlin College and Case Western Reserve University School of Medicine, she did her residency and fellowship training at the University of Washington. She has practiced in a wide variety of settings in Alaska, including the remote community of Barrow, the private sector in Anchorage, and as an emergency physician, primary care provider, and endocrinologist at Alaska Native Medical Center; she has also been involved in teaching in the UAA/WWAMI Program for many years. Dr. Southworth is an avid outdoor enthusiast, passionate about hiking, kayaking and Nordic

skiing; she is also former principal harpist with the Anchorage Symphony Orchestra. She has three young adult children and lives with her husband Bret Haering in Anchorage.

Anne L. Peters, MD, FACP

Dr. Peters is the director of the USC Clinical Diabetes Program. Dr. Peters received her medical degree from the University of Chicago Pritzker School of Medicine and completed her internship and residency in Internal Medicine at the Stanford University Medical Center. She completed an endocrinology fellowship at Cedars-Sinai Medical Center in Los Angeles. She was in charge of the Comprehensive Diabetes Program at Cedars and then moved to UCLA, where she ran the Clinical Diabetes Program there. Dr. Peters is on the Board of the American Diabetes Association and a member of the American Board of Internal Medicine (Endocrine Subspecialty Board). Her major areas of interest include developing systems of care for management and treatment of diabetes, community based diabetes research in underserved areas and in the management of type 1 diabetes. In 2008 she was awarded the ADA’s "Outstanding Physician Clinical Award".

Page 10: 2014 AKOMA ACP brochure FINAL · data quality reviews. Ms. Kuehn has authored multiple books for both the American Health Information Management Association (AHIMA) and the Medical

Mark Zaros, MD

Dr. Zaros is an Assistant Professor in the University of Washington Department of Medicine. He is also the Director of the Hospital Medicine Service at the Harborview Medical Center. Dr. Zaros graduated from the University of Miami, School of Medicine in 2004. He completed his Residency in Internal Medicine and Pediatrics at the University of Michigan in 2008. His honors include: Johns Hopkins Outstanding Performance in Chemistry, Johns Hopkins Chemistry Honors Program, Iron Arrow Honors Society, The Bronze Beeper Award, Semi-Finalist - Poster Presentation in the Research Category at the Society of Hospital Medicine's 2011 Annual Meeting, and Semi-Finalist - Poster Presentation in the Innovations Category at the Society of Hospital Medicine's Annual Meeting 2012.

Nicolas Wieder, DO

Dr. Wieder is the Physician–in-Charge of the Department of Pain Medicine at Kaiser Perman-ente Medical Center–Panorama City, CA. Dr. Wieder is a graduate of Western University Health Sciences. He completed his Internal Medicine Internship at Kaiser Permanente–West LA and his Neurology Residency at Kaiser Permanent–Los Angeles Medical Center. Dr. Wieder has a Fellowship in Anesthesia Pain Management from the Massachusetts General Hospital Harvard Medical School. Dr. Wieder is Board Certi�ed in Neurology and Pain Medicine. He serves on a Regional Opioid Task Force and is a Regional Neuropathic Pain representative for SCPMG Drug Utilization Action Team.

Al Turner, DO

Dr. Turner is Board Certi�ed in both Osteopathic Manipulative Medicine and Family Medicine. After 15 years in Family Medicine, he retooled, retested, and then spent the next 20 years in Osteopathic Manipulative Medicine. Dr. Turner graduated in 1978 from Michigan State University, College of Osteopathic Medicine. Dr. Turner was Medical Director for a chain of urgent care clinics, and Director of the Osteopathic Manipulative Medicine Department at Eastmoreland Hospital in Portland for 10 years before the hospital closed in 2003. After that, Dr. Turner started his own practice in Portland called Osteopathic Advantage. He retired in June 2013. Dr. Turner was recognized as “DO of the Year” by the Osteopathic Physicians and Surgeons of Oregon. He received the “Founders Award” from the Northwest Osteopathic Medical Foundation for Outstanding Service to the Osteopathic Profession. The American Osteopathic Association named him to the Mentor Hall of Fame and recognized him as a “Guardian of the Profession”. Dr. Turner enjoys Medical Mission trips to Third World countries

(Haiti and Peru), and is a casual student of Anthropology, Medical History, and Computers.

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Attendee’s Name

Billing Address

City/State/Zip

Email

Phone Fax

MD DO

ExpirationSecurity CodeCard Number

Name on Card

Signature

Check # Visa Mastercard AmEx Discover

Thu . . . . . . Wine and Cheese Social

Thu . . . . . . ACP Council Meeting or AKOMA Board Meeting (following the social)

Fri . . . . . . . . Hands-On US training (location: UAA/WWAMI Building; fee: $100/20 people)

Fri . . . . . . . . Banquet

[SOCIAL]

[BOARD]

[TRAIN]

[FBANQUET]

I will be attending (check all that apply): TOTAL DUE :

Guest Fee/Social

Guest Fee/Banquet

$20Guest:

$50Guest:

50% Retired Discount (members or non-members)*

20% Allied Health Pro/A�liate Member Discount *

20% Military Discount (members or non-members) *

Resident/Student

Non-Member

ACP/AKOMA Member $600$500

$700$600

$0$0

$400 (m) $480 (nm)

$250 (m) $300 (nm)

$480 (m) $560 (nm)

$400 (m) $480 (m)

$300 (m) $350 (nm)

$480 (nm) $560 (nm)

* NOTE: Limit one discount per registrant. Discounts are not stackable.

COSTEarly Bird After 4/15

Alaska ACP and AKOMA 2014 Registration FormMail this completed Registration Form to: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572 or fax it to: (215) 351-2799 (no cover sheet necessary)

[GSOCIAL]

[GBANQUET]