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PAIDPADUCAH, KY
PERMIT #44
American Society of Interventional Pain Physicians81 Lakeview Drive, Paducah, KY 42001The Voice of Interventional Pain Management
American Society of Interventional Pain PhysiciansASIPP® EDUCATIONAL SERVICES | EXCELLENCE IN THE EDUCATION OF INTERVENTIONAL PAIN PHYSICIANS
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION
HANDS-ON CADAVER WORKSHOPUp to 12.75 AMA PRA Category 1 Credits™
AND ONLINE LECTURESUp to 7.5 AMA PRA Category 1 Credits™
June 11-12 | Sheraton Memphis Downtown HotelVENUE:
SHERATON MEMPHIS DOWNTOWN HOTEL, 250 NORTH MAIN STREET, MEMPHIS, TN, 38103PHONE: 901-527-7300 | HOTEL RESERVATIONS: 866-716-8106
MEDICAL EDUCATION AND RESEARCH INSTITUTE CENTER445 CLEVELAND STREET, MEMPHIS, TN 38104 | PHONE: 901-722-8001
SPECIALS:• SPECIAL ROOM RATES THROUGH MAY 16, 2016
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION HANDS-ON CADAVER WORKSHOP Up to 12.75 AMA PRA Category 1 Credits™
AND ONLINE LECTURES Up to 11.25 AMA PRA Category 1 Credits™
June 11-12 | Sheraton Memphis Downtown HotelVENUE:SHERATON MEMPHIS DOWNTOWN HOTEL, 250 NORTH MAIN STREET, MEMPHIS, TN, 38103PHONE: 901-527-7300 | HOTEL RESERVATIONS: 866-716-8106
MEDICAL EDUCATION AND RESEARCH INSTITUTE CENTER445 CLEVELAND STREET, MEMPHIS, TN 38104 | PHONE: 901-722-8001
SPECIALS:• SPECIAL ROOM RATES THROUGH MAY 16, 2016
American Society of Interventional Pain Physicians
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION HANDS-ON CADAVER WORKSHOP AND ONLINE LECTURESJUNE 11-12, 2016 | MEMPHIS, TN
DESCRIPTIONThis lumbar intervention course includes online lectures and 1 1/2 days of cadaver workshop. Lumbar Endoscopic Spine Decompression is a minimally invasive procedure that can help relieve pain, numbness and decreased mobility caused by nerve pressure created by a ruptured, herniated or bulging disc. This technique is performed by inserting a small instrument under X-ray guidance through the skin to reach the affected disc and provide treatment.
The course will include the following: - Online lectures from recent Lumbar Endoscopic Spine Decompression Course - Eight hours of lectures broken into mainly 30 minute segments - Indications and efficacy of Endoscopic Discectomy - Technical considerations of spinal decompression - Overview of Lumbar Disc Herniation and Spinal Stenosis - Billing and coding - Equipment Overview and Discussion
The cadaver workshop will include the following: - Most comprehensive Lumbar Endoscopic Spine Decompression Cadaver Workshop available in the United States - Manipulation and placement of needle and scope - C-arm fluoroscopic units - Cadaver lab space limited to 4 physicians per station and maximum of 6 stations
TARGET AUDIENCE/PURPOSEThis comprehensive review is targeted to interventional pain physicians, neurosurgeons, and orthopedic spine surgeons seeking CME credit hours and introduction or review of transforaminal endoscopic lumbar decompression, as well as skills improvement and/or to fulfill CME hours.
OBJECTIVES - Attain understanding of Lumbar Endoscopic Spine Decompression - Attain eligibility for competency certification - Integrate new and progressive interventional pain management techniques in treating your patients so that patients have better outcomes and reduced side effects - Provide high-quality, competent, safe, accessible, and cost-efficient services to your patients
ACCREDITATION STATEMENTThese CME activities have been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint providership of The Institute for Medical Studies and the American Society of Interventional Pain Physicians. The Institute for Medical Studies is accredited by the ACCME to provide continuing medical education for physicians.
CATEGORY I CREDITThe Institute for Medical Studies designates this live activity for a maximum of 12.75 AMA PRA Category 1 Credits ™ for the Cadaver Workshop and 11.5 AMA PRA Category 1 Credits™ for Online lectures.Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AMERICANS WITH DISABILITIES ACT & SPECIAL SERVICESOrganizers fully comply with the legal requirements of the Americans with Disabilities Act and the rules and regulations thereof. If any participant in these educational activities is in need of accommodations, please contact the organizers at (270) 554-9412 at least 10 days prior to each conference.
CADAVER WORKSHOP SITEMedical Education and Research Institute Center445 Cleveland Street, Memphis, TN 38104 | Phone: 901-722-8001
THERE IS NO COMMERCIAL SUPPORT FOR THIS COURSE. NO DUPLICATION OR DISTRIBUTION OF MATERIALS, OR RECORDING OF LECTURES ASSOCIATED.
COURSE DIRECTORS
Laxmaiah Manchikanti, MDChief Executive Officer and Chairman of the Board, ASIPP®Medical Director, Pain Management Center of PaducahPaducah, KY Clinical Professor of Anesthesiology and Perioperative MedicineUniversity of LouisvilleLouisville, KY
Frank J.E. Falco, MDTreasurer, ASIPP®Medical Director, Midatlantic SpineNewark, DEClinical Assistant ProfessorTemple University Medical SchoolPhiladelphia, PA
ACCOMMODATIONS Sheraton Memphis Downtown Hotel250 North Main Street, Memphis, TN 38103Phone: 901-527-7300 | sheratonmemphisdowntown.com
Enjoy outstanding service in the warm, welcoming atmosphere of the newly renovated Sheraton Memphis Downtown Hotel. Attached to the Memphis Cook Convention Center and located as a direct stop on the vintage Memphis Main Street Trolley line, experience easy access to some of downtown’s most notable attractions. Inform the agent that you are booking for American Society of Interventional Pain Physicians. We have secured a group rate of $141. Register early, as all unbooked rooms will be released on May 16, 2016 or until sold out, whichever occurs first.
American Society of Interventional Pain Physicians
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION HANDS-ON CADAVER WORKSHOP AND ONLINE LECTURESJUNE 11-12, 2016 | MEMPHIS, TN
ONLINE LECTURES | LUMBAR ENDOSCOPIC SPINAL DECOMPRESSIONNOTE: The online Review Course videos must be viewed prior to attending the two-day course.
The cadaver workshop rotations will include: needle placement: Discography vs. Discectomy; Percutaneous Disc Decompres-sion; MILD; Endoscopic Decompression – placement of scope; Endoscopic Decompression – Disc Decompression; Endoscopic Decompression – decompression of stenosis; SI Joint Fusion; Open.
SATURDAY JUNE 11 | LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION CADAVER WORKSHOP
SUNDAY JUNE 12 | LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION CADAVER WORKSHOP
7:15am SHUTTLES DEPART FROM HOTEL TO THE CADAVER FACILITY
7:15am–7:45am REGISTRATION AND BREAKFAST
7:45am–8:00am Introduction - Frank J.E. Falco, MD
8:00am–9:00am Overview of Technical Considerations - Frank J.E. Falco, MD
9:00am–12:00pm HANDS-ON CADAVER WORKSHOP
12:00pm–1:00pm LUNCH
1:00pm–5:30pm HANDS-ON CADAVER WORKSHOP
5:30pm SHUTTLES DEPART FROM CADAVER FACILITY TO THE HOTEL
7:15am SHUTTLES DEPART FROM HOTEL TO THE CADAVER FACILITY
7:30am–8:00am REGISTRATION AND BREAKFAST
8:00am–8:30am Introduction
8:30am –12:00pm HANDS-ON CADAVER WORKSHOP
12:00pm SHUTTLES DEPART FROM CADAVER FACILITY TO THE HOTEL & TO THE AIRPORT
American Society of Interventional Pain Physicians
LUMBAR ENDOSCOPIC SPINAL DECOMPRESSION HANDS-ON CADAVER WORKSHOP AND ONLINE LECTURESJUNE 11-12, 2016 | MEMPHIS, TN
REGISTRANT INFORMATION
IMPORTANT. Please answer all the questions:
Medical Degree:m MD m DO m Additional: ____________________________
Primary Specialty Certification:m Anesthesiology m Physiatrym Neurosurgery m Other: _______________________________
Pain Medicine Subspecialty Certification:m ABMS Pain Medicine (Anesthesiology, PMR, Neurology, Psychiatry, Emergency Medicine)m American Board of Pain Medicinem American Board of Interventional Pain Physiciansm Fellow of Interventional Pain Practice (FIPP)
Specialty Designation:m 09 - Interventional Pain Managementm 72 - Pain Managementm Other: _______________________________
Years in Interventional Pain Management Practice:m 0 m 1-5 m 6-10 m > 10
Number of Years Experience in Lumbar Spinal Endoscopic Decompression:m 0 m 1-5 m 6-10 m > 10
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
RETURN COMPLETED FORM TO:ASIPP®, 81 Lakeview Drive, Paducah, KY 42001 or Fax to 270-554-5394
CANCELLATION POLICY:ASIPP reserves the right to cancel this course upon reasonable notice and will assume no financial obligation to registrants for cancellation for reasons beyond its control. Registration fees will be refunded however, costs incurred by the registrants, such as airline or hotel fees or penalties, are the responsibility of the registrants. ASIPP requires a 30-day notice of cancellation. Cancellations must be submitted in writing by May 10, 2016. Cancellations after May 10, 2016 but prior to May 26, 2016 will forfeit 50% of their registration fee. No refunds can be made after May 26, 2016
REGISTER ONLINE AT www.asipp.org/meetings.htm
REGISTRATION
REGISTRATION FOR LUMBAR ENDOSCOPIC SPINE DECOMPRESSION HANDS-ON CADAVER WORKSHOPAND ONLINE LECTURES
ONLINE LECTURES:Lumbar Endoscopic Spine Decompression
m Member $ 300 m Non Member $ 500
CADAVER WORKSHOP:Lumbar Endoscopic Spine Decompression*
m Member $3,500 m Non Member $3,800
TOTAL $ ________________________
* Non physicians may NOT attend the cadaver portion
** If registering as a fellow, please list below the name of fellowship program, university or hospital and fax or e-mail a letter from the program director verifying your status. Your application for registration cannot be processed and you will not receive the 50% discount until ASIPP receives this letter. Fax the letter to 270-554-5394 or e-mail to [email protected]
____________________________________________________________________________________________NAME OF FELLOWSHIP PROGRAM
PAYMENT METHODm MASTERCARD m VISA m AMERICAN EXPRESS m DISCOVER
_____________________________________________________________________________________________CREDIT CARD NUMBER SECURITY CODE (Back of Card) EXP. DATE
_____________________________________________________________________________________________NAME ON CARD
_____________________________________________________________________________________________AUTHORIZED SIGNATURE (required on all credit card orders)(Your application will not be processed if payment does not accompany registration form)
PLEASE PRINT EXACTLY AS YOU WISH YOUR NAME TO APPEAR ON YOUR BADGE:
_______________________________________________________________________________________________________NAME (FIRST) (MIDDLE INITIAL) (LAST)
_____________________________________________________________________________________________ORGANIZATION
_____________________________________________________________________________________________ADDRESS
_____________________________________________________________________________________________CITY STATE ZIP
_____________________________________________________________________________________________PHONE FAX
____________________________________________________________________________________________E-MAIL
