11
2019 December 12 – 14, 2019 Las Vegas, NV Advanced Team Physician Course Jointly Sponsored by:

Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

  • Upload
    others

  • View
    2

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

2 019December 12 – 14, 2019 • Las Vegas, NV

Advanced Team Physician Course

Jointly Sponsored by:

Page 2: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Advanced Team Physician Course Preliminary Program 2

COURSE DESCRIPTIONThe Advanced Team Physician Course (ATPC) is a collaborative effort between ACSM, AMSSM and AOSSM. The live activity is designed to provide up-to-date information on the evaluation and treatment of medical illnesses and musculoskeletal injuries occurring in competitive and recreational athletes. While the emphasis will be on athletes participating in team sports, many topics will be applicable to competitors in individual sports. The live activity format utilizes lectures, case presentations, debates on controversial topics, panel discussions, question-and-answer sessions as well as informal discussions with the faculty.

TARGET AUDIENCEThis conference will prove valuable to any team physician, certified athletic trainer, physical therapist or coach concerned in the management or prevention of injuries to the team athlete.

LEARNING OBJECTIVESUpon completion of this course the participant will be able to:

Perform screening for cardiac abnormalities Describe the current concepts for treatment of

ACL injuries Apply diagnostic principles to common

elbow pathology Correlate physical exam of hip and ground pain with

advanced imaging Explain treatment for cartilage and meniscus injuries

in athletes Describe sports medicine in relationship to dance Perform concussion management on the sideline Describe operative vs. non-operative management of

various orthopaedic pathologies

FACULTY

Anthony I. Beutler MD Uniformed Services University Bethesda, MD

Stephen F. Brockmeier MD University of Virginia University of Virginia

Michael W. Collins PhD Center for Sports Medicine Pittsburgh, PA

Jonathan T. Finnoff DO Mayo Clinic Minneapolis, MN

Jan Fronek MD Scripps Clinic Medical Group La Jolla, CA

Melody R. Hrubes MD University of Illinois Sports Medicine Center Chicago, IL

Mark R. Hutchinson MD University of Illinois Sports Medicine Center Chicago, IL

Peter A. Indelicato MD University of Florida Ortho & Sports Medicine Institute Gainesville, FL

Carrie A. Jaworski MD NorthShore University HealthSystem Glenview, IL

Jeffrey S. Kutcher MD Michigan Neurosport – U of M Health System Ann Arbor, MI

Volker Musahl MD University of Pittsburgh Medical Center Pittsburgh, PA

Francis G. O’Connor MD, MPH Uniformed Services University Bethesda, MD

Marc R. Safran MD Stanford Sports Medicine Center Redwood City, CA

Robert E. Sallis MD Kaiser Permanente Alta Loma, CA

Anthony R. Tabor PT Fyzical Therapy & Balance Centers Las Vegas, NV

Jan Fronek MDVolker Musahl MD

Mark R. Hutchinson MDCarrie A. Jaworski MD

Jonathan T. Finnoff DOFrancis G. O’Connor MD, MPH

COURSE PLANNING COMMITTEE

FACULTY

Page 3: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Advanced Team Physician Course Preliminary Program 3

THURSDAY, DECEMBER 12, 2019

6:45 am – 7:45 amContinental Breakfast

7:45 am – 8:00 amWelcomeVolker Musahl MDJan Fronek MD

Session I | The Preparticipation Examination 8:00 am – 10:00 am Moderator: Francis G. O’Connor MD, MPH

8:00 am – 8:05 amIntroductionFrancis G. O’Connor MD, MPH

8:05 am – 8:20 amPPE Monograph 5: What’s NewFrancis G. O’Connor MD, MPH

8:20 am – 8:40 amScreening for Sudden Cardiac Death: What Not to Miss! Francis G. O’Connor MD, MPH

8:40 am – 8:55 amThe PPE Examination: There’s More than Just the Heart Robert E. Sallis MD

8:55 am – 9:15 amSpecial Considerations in the Female AthleteCarrie A. Jaworski MD

9:15 am – 9:35 amFunctional Testing for Injury PreventionAnthony I. Beutler MD

9:35 am – 9:50 amSpecial Considerations in the Transgender AthleteCarrie A. Jaworski MD

9:50 am – 10:00 amQ & A

10:00 am – 10:15 amBreak

Session II | Cut or Not to Cut: ACL and Old Dog New Tricks (Panel Discussion) 10:15 am – 12:15 pm Moderator: Volker Musahl MD

10:15 am – 10:20 amACL Injury in the Younger Athlete (Pros and Cons)Marc R. Safran MD

10:20 am – 10:30 amACL Panel DiscussionMark R. Hutchinson MDJonathan T. Finnoff MDVolker Musahl MDJan Fronek MDRobert E. Sallis MDMarc R. Safran MD

10:30 am – 10:35 amACL Repair v. Reconstruction (Pros and Cons)Volker Musahl MD

10:35 am – 10:45 amPanel Discussion Mark R. Hutchinson MDJonathan T. Finnoff DOVolker Musahl MDJan Fronek MDMarc R. Safran MD

10:45 am – 10:50 amACL Injury in the Mature Athlete Patient (Pros and Cons)Jan Fronek MD

10:50 am – 11:00 amPanel Discussion Mark R. Hutchinson MDJonathan T. Finnoff DOVolker Musahl MDJan Fronek MDMarc R. Safran MD

11:00 am – 11:05 amACL Ortho-Biologics (Pros and Cons)Jonathan T. Finnoff DO

11:05 am – 11:15 amPanel Discussion Mark R. Hutchinson MDJonathan T. Finnoff DOVolker Musahl MD Jan Fronek MDMarc R. Safran MD

11:15 am – 12:15 pmOld Dog, New TricksMark R. Hutchinson MDFrancis G. O’Connor MD, MPH Jonathan T. Finnoff DOCarrie A. Jawrowski MDVolker Musahl MDJan Fronek MD

12:15 pm – 1:30 pm Lunch – On your own

Page 4: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Advanced Team Physician Course Preliminary Program 4

Session III | Advanced Deep Dive of the Elbow – Part 1 1:30 pm – 2:50 pm Moderator: Mark R. Hutchinson MD

1:30 pm – 1:40 pmIntroduction with Foundational Anatomy ReviewMark R. Hutchinson MD

1:40 pm – 2:00 pmPhysical Exam of the Elbow: What’s the Evidence? Marc R. Safran MD

2:00 pm – 2:15 pmCased Based Diagnostic Imaging Pearls of Elbow PathologyJan Fronek MD

2:15 pm – 2:35 pmLive Diagnostic Ultrasound of Normal and Pathologic ElbowsJonathan T. Finnoff DO

2:35 pm – 2:50 pmPanel Discussion and Q & AMark R. Hutchinson MD

2:50 pm – 3:05 pmBreak

Session IV | Advanced Deep Dive of the Elbow – Part 2 3:05 pm – 4:25 pm Moderator: Mark R. Hutchinson MD

3:05 pm – 3:20 pmTendinopathy (Tennis elbow, Golfer’s Elbow, Triceps, Distal Biceps Ruptures)Volker Musahl MD

3:20 pm – 3:35 pmElbow Injuries in the Mature Throwing AthleteMarc R. Safran MD

3:35 pm – 3:50 pmElbow Issues in the Skeletally Immature AthleteJan Fronek MD

3:50 pm – 4:05 pmElbow Dislocations and Posterolateral InstabilityMarc R. Safran MD

4:05 pm – 4:25 pmQ & A (All Speakers)Mark R. Hutchinson MD

4:25 pm – 4:40 pmBreak

Session V | Infectious Disease 4:40 pm – 6:10 pm Moderator: Francis G. O’Connor MD, MPH

4:40 pm – 4:55 pmAcute and Chronic Effects of Exercise on Immune Function Francis G. O’Connor MD, MPH

4:55 pm – 5:10 pmInfectious Skin Disorders in AthletesRobert E. Sallis MD

5:10 pm – 5:25 pmUpdate on Infectious Mononucleosis and Chronic FatigueAnthony I. Beutler MD

5:25 pm – 5:40 pmImmunizations, Pre- and Post-Exposure Prophylaxis in AthletesFrancis G. O’Connor MD, MPH

5:40 pm – 5:55 pmManaging Upper Respiratory Infectious Disease in AthletesCarrie A. Jaworski MD

5:55 pm – 6:10 pmQ & AAll Speakers

Adjourn Day 1

THURSDAY, DECEMBER 12, 2019 CONTINUED

Page 5: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Advanced Team Physician Course Preliminary Program 5

7:00 am – 7:45 amContinental Breakfast

7:45 am – 8:00 amWelcome / AnnouncementsVolker Musahl MDJan Fronek MD

Session VI | Advanced Deep Dive of the Hip – Part 1 8:00 am – 8:55 am Moderator: Mark R. Hutchinson MD

8:00 am – 8:10 am Introduction with Foundational Anatomy ReviewMark R. Hutchinson MD

8:10 am – 8:30 amHistory and Physical Exam of the Hip: What’s the Evidence? (Live Demo)Volker Musahl MD

8:30 am – 8:45 amCase Based Diagnostic Imaging Pearls of Hip PathologyMarc R. Safran MD

8:45 am – 8:55 amPanel Discussion – Cased based Diagnostic Challenges, Q & AAll Speakers

8:55 am – 9:10 amBreak

Session VII | Advanced Deep Dive of the Hip – Part 2 9:10 am – 10:55 am Moderator: Mark R. Hutchinson MD

9:10 am – 9:25 amFemoroacetabular Impingement (CAM/Pincer/Combined)Marc R. Safran MD

9:25 am – 9:40 am Coxa Sultans: Snapping Hip (ITB Syndrome, Iliopsoas, Rectus, Loose Bodies Jonathan T. Finnoff DO

9:40 am – 9:55 amHip Issues in the Skeletally Immature Athlete: SCFE, Perthes, Avulsion Injuries, DysplasiaMarc R. Safran MD

9:55 am – 10:10 amAthletic Pubalgia (Sports Hernia, Inguinal Strain, Pubic Symphasistis, Adductor Strain)Jonathan T. Finnoff DO

10:10 am – 10:25 amProximal Hamstring Injuries: Partial to Complete (Including Tendinopathy)Jan Fronek MD

10:25 am – 10:40 amPathologies about the Hip Not to Be Missed: Stress Fractures, SI Joint Dysfunction, Sciatica, Nerve Entrapments, etc. Mark R. Hutchinson MD

10:40 am –10:55 amQ & A All Speakers

Session VIII | Sports Ultrasound Cartilage Session 10:55 am – 12:55 pm Moderator: Jonathan T. Finnoff DO

10:55 am – 11:05 amIntroduction with Case PresentationJonathan T. Finnoff DO

11:05 am – 11:25 amLive Demonstration of Advance Ultrasound of the Posterior HipJonathan T. Finnoff DO

11:25 am – 11:45 amPathology and Ultrasound-Guided Interventions of the Posterior HipJonathan T. Finnoff DO

11:45 am – 12:05 pmLive Demonstration of Advanced Ultrasound of the Anterior and Lateral HipJonathan T. Finnoff DO

12:05 pm – 12:25 pmPathology and Ultrasound – Guided Interventions of the Anterior and Lateral HipJonathan T. Finnoff DO

12:25 pm – 12:45 pmUpdate on Ultrasound – Guided Surgical ProceduresJonathan T. Finnoff DO

12:45 pm – 12:55 pmQ & A

12:55 pm – 2:15 pmLunch – On your own

FRIDAY, DECEMBER 13, 2019

Page 6: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Advanced Team Physician Course Preliminary Program 6

Session IX | Cartilage 2:15 pm – 4:00 pm Moderator: Volker Musahl MD

2:15 pm – 2:30 pmAnterior Knee Pain and PFSMark R. Hutchinson MD

2:30 pm – 2:45 pmOCD LesionsPeter A. Indelicato MD

2:45 pm – 3:00 pmThe Young Knee: Meniscectomy vs. RepairVolker Musahl MD

3:00 pm – 3:15 pm Cartilage Repair: When to Treat and Not to TreatPeter A. Indelicato MD

3:15 pm – 3:30 pmRepair TechniquesPeter A. Indelicato MD

3:30 pm – 4:00 pmQ & A All Speakers

4:00 pm – 4:15 pmBreak

Session X | Expanding the Stage of Sports Medicine: Care of the Performing Artist 4:15 pm – 6:15 pm Moderator: Carrie A. Jaworski MD

4:15 pm – 4:20 pmIntroductionCarrie A. Jaworski MD

4:20 pm – 4:50 pmDance 101: Understanding the Sport of DanceAnthony R. Tabor PT

4:50 pm – 5:10 pmThe Pre-professional BallerinaCarrie A. Jaworski MD

5:10 pm – 5:30 pmThe Hypermobile Performer Melody R. Hrubes MD

5:30 pm – 5:45 pmThe Show Must Go On!All Speakers

5:45 pm – 6:00 pmCare of Musicians: The Forgotten AthleteMelody R. Hrubes MD

6:00 pm – 6:15 pmQ & A

Adjourn Day 2

FRIDAY, DECEMBER 13, 2019 CONTINUED

Page 7: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Advanced Team Physician Course Preliminary Program 7

7:00 am – 7:45 amContinental Breakfast

7:45 am – 8:00 amWelcome / AnnouncementsVolker Musahl MDJan Fronek MD

Session XI | The Ever-Evolving Care of Concussions – Where are We Now? 8:00 am – 10:00 am Moderator: Carrie A. Jaworski MD

8:00 am – 8:05 amIntroduction Carrie A. Jaworski MD

8:05 am – 8:25 amSideline Head Injury Assessment and Management – High School to the ProsRobert E. Sallis MDJeffrey S. Kutcher MD

8:25 am – 8:40 amConcussion Subtype Management Pearls Michael W. Collins PhD

8:40 am – 8:55 amEnough is Enough: Retiring an Athlete from SportJeffrey S. Kutcher MD

8:55 am – 9:25 amIs It a Concussion or Not? Carrie A. Jaworski MD Robert E. Sallis MDJeffrey S. Kutcher MDMichael W. Collins PhD

9:25 am – 9:50 am What I Tell My Patients About… 1 Chronic Traumatic Encephalopathy 2 Baseline Testing, Needed or Not? 3 Exercise is Medicine for the Concussed Brain –

Yes or No? 4 Helmet Technology – Worth the Price? 5 Hyperbaric Oxygen or Hocus Pocus? Carrie A. Jaworski MDMichael W. Collins PhDJeffrey S. Kutcher MDRobert E. Sallis MD

9:50 am – 10:00 amQ & A

10:00 am – 10:15 amBreak

Session XII | Cut or Not to Cut Shoulder Instability: Return to Play Case-Based and Examarama (Panel Discussion) 10:15 am – 12:15 pm Moderator: Volker Musahl MD

10:15 am – 10:20 amShoulder Dislocation – In SeasonVolker Musahl MD

10:20 am – 10:30 amPanel Discussion Mark R. Hutchinson MDJan Fronek MDCarrie A. Jaworski MDVolker Musahl MDRobert E. Sallis MDStephen F. Brockmeier MD

10:30 am – 10:35 amBatter’s Shoulder (Case Presentation)Jan Fronek MD

10:35 am – 10:40 amPanel Discussion Mark R. Hutchinson MDJan Fronek MDCarrie A. Jaworski MDVolker Musahl MDRobert E. Sallis MDStephen F. Brockmeier MD

10:40 am – 10:45 amPost-operative Instability (Case Presentation Stephen F. Brockmeier MD

10:45 am – 10:55 amPanel Discussion Mark R. Hutchinson MDJan Fronek MDCarrie A. Jaworski MDVolker Musahl MDRobert E. Sallis MDStephen F. Brockmeier MD

10:55 am – 11:00 amShoulder Dislocation – Rotator CuffStephen F. Brockmeier MD

11:00 am – 11:15 amPanel Discussion Mark R. Hutchinson MDJan Fronek MDCarrie A. Jaworski MDVolker Musahl MDRobert E. Sallis MDStephen F. Brockmeier MD

SATURDAY, DECEMBER 14

Page 8: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Advanced Team Physician Course Preliminary Program 8

SATURDAY, DECEMBER 14 CONTINUED

11:15 am – 12:15 pmExamarama: How They Do Exams Mark R. Hutchinson MDJan Fronek MDCarrie A. Jaworski MDVolker Musahl MDJeffrey S. Kutcher MDMichael W. Collins PhDRobert E. Sallis MDStephen F. Brockmeier MD

12:15 pm – 1:30 pm Lunch – On your own

Session XIII | To Cut or Not to Cut 1:30 pm – 3:00 pm Moderator: Mark R. Hutchinson MD

1:30 pm – 1:35 pmStress Fracture of the Anterior TibiaMark R. Hutchinson MD

1:35 pm – 1:45 pmDiscussion Mark R. Hutchinson MDVolker Musahl MDPeter A. Indelicato MDRobert E. Sallis MDJan Fronek MDCarrie A. Jaworski MD

1:45 pm – 1:50 pmPatella TendinopathyVolker Musahl MD

1:50 pm – 2:00 pmPanel Discussion Mark R. Hutchinson MDVolker Musahl MDPeter A. Indelicato MDRobert E. Sallis MDJan Fronek MDCarrie A. Jaworski MD

2:00 pm – 2:05 pmDegenerative Knee Peter A. Indelicato MD

2:05 pm – 2:15 pmPanel Discussion Mark R. Hutchinson MDVolker Musahl MDPeter A. Indelicato MDRobert E. Sallis MDJan Fronek MDCarrie A. Jaworski MD

2:15 pm – 2:20 pmAudience Challenge

2:20 pm – 2:25 pmPanel Discussion Mark R. Hutchinson MDVolker Musahl MDPeter A. Indelicato MDRobert E. Sallis MDJan Fronek MDCarrie A. Jaworski MD

2:25 pm – 2:35 pmAudience Challenge

2:35 pm – 2:40 pmPanel Discussion Mark R. Hutchinson MDVolker Musahl MDPeter A. Indelicato MDRobert E. Sallis MDJan Fronek MDCarrie A. Jaworski MD

2:40 pm – 2:50 pmAudience Challenge

2:50 pm – 3:00 pmPanel Discussion Mark R. Hutchinson MDVolker Musahl MDPeter A. Indelicato MDRobert E. Sallis MDJan Fronek MDCarrie A. Jaworski MD

Page 9: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Advanced Team Physician Course Preliminary Program 9

GENERAL INFORMATION

COURSE LOCATIONLocated at 3960 Las Vegas Boulevard, The Four Seasons Hotel Las Vegas places you in the heart of Las Vegas. A luxurious art deco-inspired rooms and suites reflect the energy and excitement of one of the world’s most vibrant cities. There’s direct access to Mandalay Bay Resort and Casino, and the city’s nightlife and entertainment. Don’t miss the elegant landscaped garden with private pool, restaurant and lounges.

HOTEL ACCOMMODATIONSA block of rooms has been reserved at The Four Seasons Hotel Las Vegas (attached to the Mandalay Bay Hotel) at a rate of $159 plus tax and a $39 daily resort fee. The resort fee includes premium high-speed internet access for multiple devices in guest rooms as well as the pool and lobby, free local calls, and in-room coffee and tea maker. Reservations may be made by calling 877.632.5000. Specify that you are attending the AOSSM Meeting. You can also book directly online at www.sportsmed.org. The reservation deadline is November 12, 2019. Cancellations must be made 48 hours prior to arrival. Rooms are guaranteed until this date pending availability. Attendees are encouraged to book early.

Registration received by November 12, 2019

Registration received after November 12, 2019

If staying at The Four Seasons Hotel

If staying at another hotel

If staying at The Four Seasons Hotel

If staying at another hotel

Members of ACSM, AMSSM, AOSSM $650 $800 $700 $850

Non-Members $750 $900 $800 $950

REGISTRATION INFORMATION

NOTE ON FEE DIFFERENTIALRegistration costs are predicated on attendees staying at the Four Seasons Hotel Las Vegas. A $150 USD differential is assessed to registrants staying at other hotels to offset expense incurred. Meeting registrants will be confirmed with the Four Seasons Hotel master list (the above registration fees do not include hotel).

CANCELLATION / REFUND POLICYA written request to cancel must be received in the AOSSM office prior to November 12, 2019. The registration fee, minus a $150 processing fee, will be refunded following the conference. No refunds will be made after November 12, 2019.

*Students, residents and individuals in a fellowship program can deduct $100 from the above fees (proof to be included with registration).

On-site registration will open on Thursday, December 8 at 6:00 am and continue daily throughout the course hours.

Page 10: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Advanced Team Physician Course Preliminary Program 10

STATEMENT OF NEEDA need for this live activity has been determined by identifying professional practice gaps and reviewing previous course evaluations. The content of this course is based on current issues and hot topics provided by ACSM, AMSSM and AOSSM membership and leadership.

PROGRAM AOSSM attest that the people responsible for the development of this live activity did so independently and were not influenced by commercial supporters.

DISCLOSURE STATEMENTIn accordance with the guidelines of the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the AOSSM that faculty and planners disclose to the learners all financial relationships during the past twelve months with any commercial interest (any entity producing, marketing, re-selling, or distributing health care goods and services consumed by, or used on, patients). Any and all disclosures will be provided in the final program that is distributed at the meeting to program participants. In accordance with AOSSM policy, faculty participation is predicated upon timely submission and review of AOSSM disclosures. Non-compliance results in faculty being stricken from the program.

DISCLAIMERThe material presented in this continuing medical education program is being made available by the ASCSM, AMSSM and AOSSM for educational purposes only. This material is not intended to represent the only methods or procedures appropriate for the medical situation discussed, but rather it is intended to present an approach, view, statement, or opinion of the faculty, which may be helpful to others who face similar situations. Neither the content (whether written or oral) of any course, seminar or other presentation in the program, nor the use of a specific product in conjunction therewith, nor the exhibition of any materials by any parties coincident with the program, should be construed as indicating endorsement or approval of the views presented, the products used, or the materials exhibited by the ACSM, AMSSM or AOSSM, or its Committees, Commissions, or Affiliates. The ACSM, AMSSM and AOSSM make no statements, representations or warranties (whether written or oral) regarding the Food and Drug Administration (FDA) status of any product used or referred to in conjunction with any course, seminar or other presentation being made available as part of this course. Faculty members shall have sole responsibility to inform attendees of the FDA status of each product that is used in conjunction with any course, seminar or presentation and whether such use of the product is in compliance with FDA regulations.

CONTINUING MEDICAL EDUCATION CREDITThe American Orthopaedic Society for Sports Medicine (AOSSM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. AOSSM designates this live activity for a maximum of 22 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CONTINUING EDUCATION FOR ATHLETIC TRAINERS

The American Orthopaedic Society for Sports Medicine (AOSSM) (BOC AP#: P460) is approved by the Board of Certification, Inc. to provide continuing education for Athletic Trainers. This program is eligible for a maximum

of 22 Evidence-Based Practice Category (EBP) hours / CEUs. ATs should claim only those hours actually spent in the educational program.

AAFP CREDITSApplication for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending.

GENERAL INFORMATION CONTINUED

Page 11: Advanced Team Physician Course - ACSM · Advanced Team Physician Course Preliminary Program 2 COURSE DESCRIPTION The Advanced Team Physician Course (ATPC) is a collaborative effort

Jointly Sponsored by: 2 019December 12 – 14, 2019 • Las Vegas, NV

Advanced Team Physician Course

REGISTRATION FORMAdvance Registration closes November 12, 2019

Online registration available at www.sportsmed.org

Please register online to reserve a place for the conference. You have the option to pay by credit card when registering online. A receipt will be generated upon completion of your online registration. When mailing your check payment to the AOSSM office, please include a copy of your online registration receipt. If you prefer to fax or mail in your registration, your spot is not guaranteed until your registration is processed. For faxed or mailed registration, please return this form — type or print legibly. One form must be completed for each registrant. Advance registration will be accepted through November 12, 2019. Register early!

_____________________________________________________________________________________________________________________________________________________________LAST NAME FIRST NAME DEGREE(S)

_____________________________________________________________________________________________________________________________________________________________ADDRESS

_____________________________________________________________________________________________________________________________________________________________CITY STATE ZIP COUNTRY

_____________________________________________________________________________________________________________________________________________________________E-MAIL

_____________________________________________________________________________________________________________________________________________________________OFFICE PHONE CELL PHONE

PHYSICAL OR DIETARY REQUIREMENTSPhysical or dietary restrictions (not food preferences) requiring accommodation in order to fully participate in the conference.( There may be additional cost for dietary needs, dependent upon hotel / venue charges)

____________________________________________________________________

____________________________________________________________________

MEMBERSHIPPlease indicate each organization of which you are a member:

AMSSM ACSM AOSSMSPECIALTY: (Please check one box only)

Emergency Medicine Orthopaedic Surgery Family Medicine Physiatry (PM&R) Internal Medicine Pediatrics Other: _________________________________

TEAM PHYSICIAN: (Check each applicable box) Team Physician High School Collegiate Professional Olympic / Elite Other: _________________________________

How many Advanced Team Physician Courses have you attended? ______ What years? _________________________

FEE SCHEDULE (All fees quoted reflect US dollars.)The fee for meeting registration does not include hotel If staying at The Four If staying at Seasons Hotel another hotelMember of AMSSM | ACSM | AOSSM

Registration received by 11/12/19 $650 $800 On-Site Registration $700 $850

Non-Members Registration received by 11/12/19 $750 $900 On-Site Registration $800 $950

* Students, residents and individuals in a fellowship program can deduct $100 from the above fees (proof to be included with registration).

PAYMENT IS REQUIRED WITH THE SUBMISSION OF A REGISTRATION FORM Mail form and payment to: AOSSM, 2884 Momentum Place, Chicago, IL 60689 – 5328 Make check payable in US Dollars to American Orthopaedic Society for Sports Medicine (AOSSM) or provide credit card information and fax form to 847.655.2784. Your canceled check is your receipt.

NOTE ON FEE DIFFERENTIALRegistration costs are predicated on attendees staying at the Four Seasons Hotel Las Vegas. A $150 USD differential is assessed to registrants staying at other hotels to offset expense incurred. Meeting registrants will be confirmed with the Four Seasons Hotel master list (the above registration fees do not include hotel).

AOSSM IMAGE / LIKENESS / VOICE RELEASEI understand and agree that, as a result of participating in an AOSSM educational conference or meeting, my image, likeness, or voice may be photographed and / or recorded. If family members are attending the meeting with me, their image, likeness, and voice may also be photographed and / or recorded. I hereby grant irrevocable and unrestricted permission to AOSSM and its staff to use my or my family’s image, likeness, or performance in any medium and for any purpose they deem appropriate. I hereby waive any right to inspect or approve such use of materials. Submission of this form for meeting registration acknowledges acceptance of these terms.

REFUND POLICY AGREEMENT BY ATTENDEERefund Policy: A written request must be received in the AOSSM office by U.S. Mail or emailed to [email protected] by November 12, 2019. The registration fee minus a $150 USD processing fee will be refunded. No refunds will be accepted after November 12, 2019. Refunds will not be issued for cancellations made after the course begins for no-shows

I agree and accept the refund policy as stated above._______________________________________________________________________________SIGNATURE

PAYMENT

Total amount enclosed .................................... $

Check enclosed (See details for payment by check) Visa MasterCard Discover AMEX

______________________________________________________________________________CARD NUMBER______________________________________________________________________________EXPIRATION DATE (MM/YY) SECURITY CODE (CVV)______________________________________________________________________________NAME ON CARD

I agree to pay according to the credit card issuer agreement.______________________________________________________________________________SIGNATURE______________________________________________________________________________DATE

SECURED ONLINE REGISTRATION AVAILABLE AT www.sportsmed.org

_____________________________________________________________________________________________________________________________________________________________NICKNAME OR FIRST NAME COMPANY/AFFILIATION

_____________________________________________________________________________________________________________________________________________________________FULL NAME CITY STATE/PROVINCE

BADGE INFORMATION