Register for Our 2010 Conference Now!

Submitted by admin on Wed, 01/27/2010 - 12:21
in

You have two options for registering for our conference:

  1. Fill out our online form below. One online form for each attendee is needed. Complete each online form separately and submit them to us. After submitting the online forms, pay via our PayPal buttons. You don’t have to be a PayPal member to charge your payment to your credit card. If you prefer, you may fill out the online forms and then send a check to us at the address above. If you prefer paying by check, please see the information in the following paragraph.

    2. OR

  2. Print out the pdf version of the registration form below and mail it back to us at:
    PSC Partners Seeking a Cure
    5237 So. Kenton Way
    Englewood CO 80111

 Click here to download a PDF version of the registration form. Print out the pdf form, fill out all of the required information, and mail it to us at:

PSC Partners Seeking a Cure
 5237 So. Kenton Way
Englewood CO 80111

You may pay your registration fees by writing out a check to PSC Partners Seeking a Cure or pay by PayPal. You don’t have to be a PayPal member to charge your payment on to your credit card. If paying by check, please send us this information:

  • List of names attending
  • If you are attending the Friday brunch ($10 per person) and which registrants are attending.
  • Total Fees

Registration Fees:
Standard (on or before April 12): $150 per person, $280 per couple, $140 per additional family member or caregiver.
Late (after April 12): $170 per person, $320 per couple, $160 per additional family member or caregiver.

Pre-conference brunch: $10 per person
All fees must be received by May 1

If this is your first time attending one of our patient conferences, please take a look at this FAQ sheet.

Online Registration Form

* Denotes Required Field
** Each attendee will need to fill out a separate registration form

First Name *

Last Name *

Email *

Address *

City *

State / Province *

Country *

Zip *

Home Phone *

Mobile

Age of PSC patient IF younger than 40

Check Which Applies: *
PSC Patient
Transplant Recipient
Friend, Relative, Caregiver

List other people who are attending with you. Relationship? *

Is this your first time at a PSC Partners conference? *
Yes
No

If yes, would you like to be introduced to a mentor in the group?
Yes
No

I would like my: Name, Address, Email (check all that apply) to be included in the 2010 conference attendee booklet to be handed out to conference attendees. *
Name
Email
Address
None of the Above

How did you hear about PSC Partners Seeking a Cure conference? *
Attended a past conference
Yahoo! support group
Web search
Physician
Other (explain below)

Will you be staying at the Marriott Hartford Downtown? *
Yes
No
If yes, what is the name on the hotel reservation?

Will you join us for the Friday activities? *
Yes
No

Please select which activities you will attend:
"Get Acquainted Brunch" at 10:30am
"Introduction to Healthy Living Choices: Your chance to try yoga, tai chi, etc" 2:00-4:00pm
Dinner/Reception at 5:30pm

Will you join us for the Saturday night banquet? *
Yes
No

Do you need gluten free meals? *
Yes
No

Do you need vegetarian meals? *
Yes
No

Please choose ONE group for Saturday's lunch: *
Male PSCers
Female PSCers
Spouses/caregivers of PSCers
Siblings / other caregivers of PSCers
Parents of Pediatric PSCers (include age of child)
Parents of Adult PSCers (include age of child)
Teen PSCers (include age of child)
Male PSCers in their 20s/30s
Female PSCers in their 20s/30s
Post-transplant PSCers

Choose ONE speaker for each session. *

Session I 1:45-2:20 p.m.
Special Topics for 20s/30s Females-Dr. Tamar Taddei
Special Topics for 20s/30s Males-Dr. Dwain Fehon
The Role of Good Nutrition in PSC-Erin Paice
Surgical and Transplant Options for PSC-Dr. David Hull
Pediatric and Adolescent PSC-Dr. Karan Emerick
The Transplant Experience: Interactive Session for Post-Transplant PSCers-Dr. Aubrey Goldstein
Treatment Issues for PSC Patients with IBD-Dr. Deborah Proctor

Session II 2:30-3:05 p.m.
Know Your Rights: Health Insurance-Jennifer Jaff, Esq.
Oncologic Complications of PSC-Dr. Mario Strazzabosco
Future Plans for the Norwegian Research Center-Dr. Trine Folseraas
Endoscopic Diagnosis and Management of PSC-Dr. Priya Jamidar
Patient Perspective on the Transplant Experience-Panel of Post-Transplant PSC Patients
Coping with PSC for PSC Patients-Dr. Dwain Fehon
Treatment Issues for PSC Patients with IBD-Dr. Deborah Proctor

Session III 3:15-3:50 p.m.
Know Your Rights: Employment-Jennifer Jaff, Esq.
Adult and Pediatric PSC: Who and When to Transplant (MELD Score Advocacy)-Dr. Pramod Mistry and Dr. Tamar Taddei
The Role of Good Nutrition in PSC-Erin Paice
Endoscopic Diagnosis and Management of PSC-Dr. Priya Jamidar
Oncologic Complications of PSC-Dr. Mario Strazzabosco
Living with PSC: Stories of Inspiration-Panel of PSC Patients
Coping with PSC for Caregivers-Dr. Dwain Fehon

Will you be participating in The Itching for a Cure/Road to Connecticut fundraiser? *
Yes
No

Payment Options: *
I am paying online with PayPal
I am paying with a check


Registration Fees:
Standard (on or before April 12): $150 per person, $280 per couple, $140 per additional family member or caregiver.
Late (after April 12): $170 per person, $320 per couple, $160 per additional family member or caregiver.

Pre-conference brunch: $10 per person
All fees must be received by May 1

Conference fee includes: Friday night reception, breakfast, lunch, snack and banquet dinner Saturday, breakfast and snack Sunday, presentations, breakouts, open forums and all conference materials. Conference fee applies to ALL those who attend ANY PART of our conference and cannot be pro-rated.

Conference fee receipts will be sent to your email address. If you DO NOT have an email address and would like a receipt, please include a mailing address.

Please reserve your hotel room as soon as possible to take advantage of our special discounted room rate at the Marriott.

Please consider participating in The Itching for a Cure/Road to Connecticut fundraiser. All donations go directly to support PSC research. For more information, click here.

If you aren't already on our mailing list, please sign up now to receive e-mail updates about the conference and other programs.

As soon as we receive your registration form and registration fees, we will send you a confirmation letter.

We’re looking forward to seeing you on May 14th. If you have any questions, feel free to write to Ricky at contactus@pscpartners.org

Please note!
Information on this website has been compiled by persons without formal medical training. Therefore, the  information is not intended nor implied to be a substitute for professional medical advice.

Please consult with your doctor before using any information presented here for treatment. Nothing contained in this website is intended to be for medical diagnosis or treatment. The views and opinions expressed in the site are not intended to endorse any product or procedure.