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Course/Event Signup

Pain and Opiates in the Workplace:
Medical, Legal and Practical Issues
10th World Congress on Pain
 IASP Official Satellite Symposium
August 12-13, 2002
 Stanford, California, USA.
12 CME Pain Credits Applied For
 Fees: (add an additional $50.00 per person to listed fees if registering after 7/29/02)
IASP/CLIP Member - $200.00
Non-IASP Attendee - $350.00
Group Rate* - $300.00
Stanford Medical Faculty - $285.00
Trainee** - $150.00
One-Day Registrant - $200.00
* The Group Rate is for 3 or more pre-registered attendees from the same practice, hospital or university signing up at the same time - applies to Non-IASP attendees only.
** Trainees include: students, interns, residents, fellows - with a letter on school letterhead from your program, if non-Stanford.
Continental Breakfast and Lunch provided both days.
The Department of Anesthesia gratefully acknowledges Abbott Laboratories, Merck and Co., Inc., and Purdue Pharma L.P. for their support of this course.
 For further information contact: Amy Thoms, Course Manager
Voicemail: (650)723-2790 email: athoms@stanford.edu
Instructor: Sean Mackey, M.D., Ph.D.
Stanford University, USA
Location: To Be Announced

This multi-session course/event is offered on these dates. All sessions must be attended.

Session 1 Date:8/12/2002 Start Time:7:30:00 AM End Time:5:00:00 PM
Session 2 Date:8/13/2002 Start Time:7:30:00 AM End Time:5:00:00 PM

To register, please fill out the information below.

First Name *
Last Name *
Title *
Address *
City *
State *
Zip *
Email *(Essential for reminders and notices)
Work Phone *
Fax *
Type of Student
Country *
Medical License Number (Required to receive a CME certificate/credit)
Organization/Institution *(Essential for group discount)
Attending which day(s)? *
Vegetarian? Yes/No