Document 6603975

registration form
understanding
memory loss:
strategies for success VI
Please photocopy this form for multiple registrations
Name____________________________________________
Company_________________________________________
Address__________________________________________
City________________________St_______Zip___________
Daytime Phone (
A Napa Valley Education Conference
for Family Caregivers and Professionals
)_______________________________
E-mail Address____________________________________
q I would like a vegetarian lunch
q I would like CEUs. My license type is:
q RN q LVN q CNA/HHA q MFT q LCSW q RCFE
License #:_________________________________________
Fees: Until November 14:
________ $35 General Registration
________ $55 Professionals (including CEUs)
After November 14:
________ $40 General Registration
________ $60 Professionals (including CEUs)
________ Total Amount Enclosed
Send registration form(s) along with check to:
Alzheimer’s Association
1211 N. Dutton Ave., Suite A
Santa Rosa, CA 95401
Credit Card Payment
Continuing Education Units
Please Note: Those requesting CEUs will not be allowed late arrival.
Pre-registration is necessary, and obtainment of credits requires sign-in at the
beginning of event, and sign-out and submission of an evaluation survey at
end of day; no mailed evaluations will be accepted. Certificates will be mailed to
participants after the conference.
For health care professionals, this course has been approved by the California
State Board of Registered Nurses (BRN), for RNs and LVNs– 6 hours, Provider
No. CEP 12415; LCSW and LMFTs have been approved by the California Board of
Behavioral Science – 6 hours, Provider No. PCE1121; CNA and HHA approved by
the Department of Health Services – 6 hours, Provider No. 06329; RCFE pending
approval by the Administrator Certification Program – 6 hours.
800.272.3900
www.alz.org/norcal
Secure online registration at
http://edconference.kintera.org/Napa2014
Northern California & Northern Nevada
North Bay Area
1211 N. Dutton Ave., Suite A
Santa Rosa, CA 95401
Please call the Alzheimer’s Association at 707.573.1210.
Napa Education Conference - December 4, 2014
Payment by check
Thursday, December 4, 2014
8:30 am to 4 pm
Yountville Community Center
6516 Washington Street
Yountville
Napa Valley Hospice
Adult Day Services
Compassion. Dignity. Connection.
Understanding Memory Loss:
Strategies for Success VI
Thursday, December 4, 2014
8:30 am to 4 pm
Yountville Community Center
6516 Washington Street
Yountville, CA
agenda
7:45 am Registration & Continental Breakfast
8:30 am
8:45 am
9:45 am
WELCOME & INTRODUCTIONS
William Fisher, CEO, Alzheimer’s Association of
Northern California & Northern Nevada
ALZHEIMER’S DISEASE: THE LATEST UPDATES
ON DIAGNOSIS AND TREATMENT
Geoffrey A. Kerchner, MD, PhD, Assistant
Professor of Neurology & Neurological Sciences,
Stanford University School of Medicine
The Alzheimer’s Association, in partnership with
Napa Valley Hospice & Adult Day Services and
the Town of Yountville, presents its sixth annual
education conference in Napa Valley. Understanding
Memory Loss: Strategies for Success VI is a six-hour
conference for family members and professionals
(continuing education units are available) that
combines many topics relating to Alzheimer’s disease
and dementia. We hope that you will join us for this
outstanding program.
11:15 am QUESTION AND ANSWER DISCUSSION
William Fisher facilitates an armchair discussion with
Dr. Kerchner and Dr. Landsverk
12:00 pm Lunch (box lunch provided)
12:45 pm INSIGHTS INTO EARLY DEMENTIA
Early Stage individuals share their experiences
1:30 pmBreak
1:45 pm
Break
10:00 am MEDICATION MISMANAGEMENT: HOW
MEDICATIONS AFFECT DEMENTIA & BEHAVIOR
Elizabeth Landsverk, MD, ElderConsult Geriatric
Medicine
11:00 amBreak
General Registration Professionals (CEUs included) 2:45 pm
SOMETIMES YOU GOTTA LAUGH
Karen Stobbe, nationally recognized speaker in
dementia care
4 pm
Closing Remarks & Evaluations
Homemakers/Caregivers
to Nursing Services
Caring for Infants to Grandparents
(and All Ages In Between)
SILVER
Emeritus at Villa Del Rey
Hired Hands Homecare
Home Instead Senior Care
Senior Helpers North Bay
PARTNERS
Area Agency on Aging serving Napa and Solano
Napa Long-Term Care Ombudsman
Redwood Caregiver Resource Center
Rianda House Senior Activity Center
presented by
Six (6) Continuing Education Units available for the
following:
RN/LVN
Provider #CEP12415
LCSW/MFT
RCFE Administrator
Provider #PCE1121
Application Pending
$40.00
$60.00
WR
NOTE: Refunds will be made only if request is
received in writing by November 24, 2014.
Registration Rates after November 14, 2014
General Registration Professionals (CEUs included)
%RUQ $JH
2:30 pmBreak
Fees include continental breakfast & lunch.
$35.00
$55.00
GOLD
STRESSBUSTERS! - WHO YA GONNA CALL?
Deanna Randall, MSW, Alzheimer’s Association,
and Tiffany Pippen, MSW, Family Caregiver Alliance
registration information
Early Bird Registration Rates
(before or on November 14, 2014)
sponsors
CNA/HHA
Provider #06329
Napa Valley Hospice
Adult Day Services
Compassion. Dignity. Connection.