Sneak P eak.... FOCUS on these Highligh ts Earn up to 28.25 total

Registration provides CME, including credit reported by KAFP for each KAFP member; online
handouts; Internet connection; access to exhibits; refreshments; opportunity to enter prize
drawings; and meals (including 2 complimentary tickets to the President’s Dinner).
Secure online registration is available at http://www.kafponline.org
REGISTRATION
1. Information
7570 W. 21st St. N. #1046C
Wichita, Kansas 67205
SAM Group Learning Session: June 10, 2015, 1-5 pm
2015 KAFP Annual Meeting: June 11-13
Wichita Marriott Hotel
Name:
Print as it should appear on badge. John Smith, MD, FAAFP (example)
Guest:
Address:
City/Zip:
CME
Earn up to
28.25 total
credits
Phone: E-mail:
5. Dietary Needs
2. Meeting Registration: Please CIRCLE membership type and full conference or day(s)
you plan to attend below.
MEMBERSHIP
TYPE
Indicate special dietary need or food allergy:
THURSDAY
ONLY
FRIDAY ONLY
SATURDAY
ONLY
Active Member
$290
$155
$155
$155
Life Member
$115
$65
$65
$65
Resident Member
No charge
No charge
No charge
No charge
6. Payment
Student Member
No charge
No charge
No charge
No charge
Non-Member Physician
$340
$175
$175
$175
Allied Health Professionals
$165
$90
$90
$90
$ ______ Registration TOTAL
$ ______ Additional Activity/Contribution TOTAL
$ ______ Late Fee: $35 after June 1
_______________________________________
REGISTRATION TOTAL $
3. Meals, Activities, Contributions: Please indicate how many persons for each meal/activity.
DATE
Sneak Peak....FOCUS on these Highlights
Wed., June 10
WEDNESDAY
Pre-session: SAM Group Learning: Care of the Vulnerable Elderly,
June 10, 2015, 1-5 pm at the Marriott Hotel, Wichita, KS. Additional registration fee applies.
THURSDAY
Town Hall: Our first Annual Meeting focus is on the Town Hall Meeting and
Legislative Update. Enjoy lunch and interact with leaders.
Support KAFP-Foundation: The KAFP-F Silent Auction will be open Thurs-Fri.
There will be a variety of interesting items to bid on and it is for a worthy cause!
You are also invited to attend the popular Wine Tasting Fundraiser Thursday
evening, a charity event in the home of Dr. Sheryl Beard and Mr. Steve Johnson.
All proceeds benefit the KAFP-Foundation. The evening includes a live auction of
wines! Light hors d’œuvres will be served. You may wish to eat before, as this will
not be a full meal.
FRIDAY
Fun Run/Walk: Focus on good health bright and early at the KAFP Fun Run/Walk.
Keynote: Peter Anderson, MD will present The Familiar Physician: Saving your Doctor in the Era of Obamacare.
Member Meeting: Elect your 2015-16 officers. Special award and scholarship recipients will be honored.
President’s Dinner: Recognize the 2015 Kansas Family Physician of the Year. See your new officers installed, including Diane Steere,
MD of Wichita as your 2015-16 president.
SATURDAY
Poster Contest: Learn from and be inspired by residents and medical students!
Tracks: An interactive student workshop, a peds track and short 15 minute presentations by residents will keep you captivated. The
meeting will close at noon following a plenary wrap-up session.
__________________________________________
FULL CONFERENCE
EVENT
NUMBER
Pre-session:
SAM Group Learning:
Care of the Vulnerable Elderly
FEE
MY FEE
$150 for $
Members/
$250 Nonmembers
Thurs., June 11
Lunch
Thurs., June 11
Wine Tasting Fundraiser to benefit
the KAFP-Foundation. Tax deductible
contribution. (optional)
$75/ticket $ Roundtrip shuttle service from
Marriott Hotel to Wine Tasting
$5/person
No charge
________________________________________
$ ______ TOTAL PAYMENT
p CHECK ENCLOSED (payable to KAFP)
pVISA pMASTERCARD pDISCOVER
Card # ________________________________
______________________________________
Exp. Date: ___________CVS Code___________
Name as it appears on card:(Please Print)
______________________________________
Fri., June 12
Fun Run/Walk participant(s)
Indicate t-shirt size(s)__________
No charge
Fri., June 12
Continental Breakfast
No charge
Fri., June 12
Member Meeting Lunch
No charge
Fri., June 12
President’s Dinner- 2 complimentary
No charge
Fri., June 12
Additional President’s Dinner tickets
$75/ticket $
Billing Address/City/State/Zip:
______________________________________
______________________________________
______________________________________
Signature: _____________________________
Thank You.
Sat., June 13
Presidential Circle Breakfast
(for officers and past Presidents)
No Charge
Sat., June 13
Breakfast
No charge
Sponsor a medical student Tax deductible contribution.
Printed copy of handouts (Handouts will be available online prior
to conference. Wireless Internet connection will be available.) $100/each $
$50/printed $
handouts
ADDITIONAL ACTIVITY / CONTRIBUTION TOTAL $
RETURN WITH PAYMENT OR CALL:
Kansas Academy of Family Physicians
7570 W. 21st St. N. #1046C, Wichita, KS 67205
316.721.9005 | 800.658.1749 | fax 316.721.9044
CANCELLATION POLICY: Written requests for
cancellation will be refunded less a $35 administrative fee if received no later than June
1, 2015. Later cancellations and no-shows are
not eligible for a refund.
Thursday, June
(5.75 credits)
FOCUS
ON11 FAMILY
MEDICINE MEETING SCHEDULE • JUNE 11-13, 2015 • Wichita Marriott Hotel
Wednesday, June 10
Friday, June 12
1 – 5 pm
6 – 7 am
Fun Run/Walk
7:15 – 4
Registration Open
Thursday, June 11
7:15 – 7:45 Breakfast in the Exhibit Hall
8:45 –10 am 7:45 – 8:15
Effective Collaboration with PAs and
APRNs, Lynn Fisher, MD
8:15 – 9:15
AAFP Chapter Lecture Series: Treating
Obesity in Adult Patients, Thomas Kintanar,
MD, FAAFP, DABFM This activity is supported by
Pre-session - SAM Group Learning:
Care of the Vulnerable Elderly, Sheryl Beard, MD
KAFP-Foundation (KAFP-F) Board of Trustees Meeting & Breakfast
11 am – 5 pm Registration & KAFP-F Silent Auction open
11 – 11:30
Break, visit exhibits
an educational grant from Takeda Pharmaceuticals
International, Inc., U.S. Region; Orexigen; and Eisai Inc.
11:15 – 12:15 Lunch with Town Hall Meeting & Legislative Update, Doug Gruenbacher, MD, KAFP President
& Dodie Wellshear, Governmental Liaison
9:15 – 9:45
Break, visit exhibits
12:15 – 12:30 Break, visit exhibits
9:15 – 3:30 KAFP-F Silent Auction
12:30 – 2:30
ER/LA Opioid REMS: Achieving Safe Use While Improving Patient Care, Carol Havens, MD
This educational activity is supported by an independent educational grant from the ER/LA Opioid Analgesic REMS Program Companies (RPC). Please see www.er-la-opioid REMS.com for a listing the member companies. This activity is intended to be fully-complaint with the ER/LA Opioid Analgesic REMS education requirements issued by the US Food & Drug Administration (FDA).
2:30 – 2:45 Functional Abdominal Pain Presentation in a Clinical Setting, Kelsey Berlin, DO
2:45 – 3
What’s New with IUD Contraceptives? Bryson Hollingshead, DO
3 – 3:30
Break, visit exhibits
3:30 – 3:45
Three New USPSTF Guidelines for 2014 you need to know, Jonathan Philippe, MD
3:45 – 4:15
AAFP Update,
Robert Wergin, MD, AAFP President
4:15 – 4:30
Hyertension in Pregnancy: Evidence-Based Guidelines for Clinical Practice, Leah Peterson, MD
4:30 – 5:30
Proximity to Colorado & Legalized Marijuana: One Toke Over the (State) Line, Moderator: Doug Gruenbacher, MD; Panelists: Roger Trotter, MD; Lisa McPherson, JD & Steven Wright MD
5:30 – 6 Bonus session: ICD-10: Hitting the Panic Button! Jen Brull, MD
7 – 9:30
Wine Tasting Fundraiser
9:45 – 11:00 KEYNOTE: The Familiar Physician: Saving your Doctor in the Era of Obamacare, Peter Anderson, MD
11:00 – 11:30
Break
11:30 – 12:15 Culture Change in Pursuit of Team Based
Care and Population Health,
Terry L. Mills, MD
12:15 – 1:10
Lunch & Recognitions
1:10 – 2
Member Meeting & Election
2 – 3
New Guidelines for Cancer Screening,
Gary Doolittle, MD
3 – 3:30
Break, exhibitors leave and KAFP-F
Silent Auction closes at 3:30
3:30 – 3:40
Prize Drawings
3:40 – 4:10
Urology and Men’s Health,
Gretchen Dickson, MD
4:10 –5:10
Focus on PCMH: Panel Discussion,
Moderator, Jen Brull, MD; Panelists: Mike
Munger, MD; Terry L. Mills, MD; Beth Loney,
MD; and Allie Lohrmeyer, MD
Saturday, June 13
7 – 8 am
Presidential Circle Breakfast
7 – 8:15
Breakfast & Child Abuse Investigations,
Terra Frazier, DO
Poster Presentations
8:15 – 9
TRACK A:
*9 – 9:30
Pediatric GERD & Nocturnal Enuresis, Robin Walker, MD
*9:30– 10
Breastfeeding Basics, Tracy Williams, MD
10 – 10:15 Break
*10:15 – 11:15 Essential Skills & Tools You Need to Recognize Developmental Problems,
Pam Shaw, MD Track B:
*9 – 9:15
All You Need to Know About FOAMed, Matthew Downen, MD
*9:15 – 9:30 ADHD Treatment Expectations & Frustrations, Charles Armstrong, DO
*9:30 – 9:45
Encopresis Treatment & Prevention, John Moultrie, MD
*9:45 – 10
Etiology & Treatment of Motion
Sickness, Candice Coffey, MD
10 – 10:15 Break
*10:15 – 10:30 What’s New in HIV: Screening and
Pre-exposure Clinical Guidelines, Sara Lowery, MD
*10:30 – 10:45 Asthma Screening and Treatment in a Hospitalized Patient,
Emily Heronemus, DO
*10:45 – 11
Molar Pregnancy: A Case Study,
Danielle Wurtz, DO
*11:00 – 11:15 Ankyloglossia in a Newborn,
Rachael Svaty, MD
Track C:
*9 – 11:15 Track C: Student Workshop: Latex
to Laryngoscopy, Jen Brull, MD
Closing Plenary:
11:15 – Noon
What I Learned at the KAFP Meeting This Year, Rick Kellerman MD
5:10
Check out KAFP-F Silent Auction items
6:30 -7:30
Reception (Photo Booth 6:30-8:30)
12:15 – 2:30 pm Board of Directors Working Lunch and Summer Board Meeting
7:30 – 9:30 President’s Dinner
* Concurrent sessions 2015 Annual Meeting Supporters (as of 03/11/15): Blue Cross Blue Shield of Kansas (Fun Run) | KaMMCO (Tote Bags) | Kansas Chapter,
American Academy of Pediatrics (Educational Grant) | Kansas Foundation for Medical Care (Tote Bags) | The RE-POWER Trial (Rural Engagement in Primary Care for Optimizing Weight Reduction) and Frontiers, Heartland Institute for Clinical and Translational Research (President’s
Dinner & Reception – partial) | University of Kansas Medical Center (Refreshment Break and Tote Bags) | United Methodist Health Ministry
Fund (Educational Grant) | Wichita Nephrology Group, P.A.
Dear Friends,
Please join us at the 2015 KAFP Annual Meeting
“Focus on Family Medicine” June 11-13 at the
Wichita Marriott Hotel. This 3-day event is the
highlight of the year for family doctors from all
parts of the state to meet, enjoy fellowship and earn CME. We are
pleased to offer a June 10 Pre-session: SAM Group Learning. We
have lots of great activities and CME planned. Whether near or far,
rural or urban, I hope each of you will join us to focus on family
medicine!
Sincerely,
Doug Gruenbacher, MD, President
Professional Development
Committee
Chair, Beth Loney Oller MD, Stockton
Committee Members:
Ron Brown MD, Wichita
Sandra Archer MD, Leawood
Sheryl Beard MD, Andover
Jen Brull MD, Plainville
Eric Clarkson DO, Pratt
Kari Clouse MD, Augusta
Carolyn Gaughan, Executive Dir.
Michael Kennedy MD, Lenexa
Joshua Plank MD, Kansas City
THANK
YOU
Scott Rempel, Salina
Aaron Sinclair MD, Wichita
Margaret Smith MD, Kansas City
Diane Steere MD, Wichita
Mark Stovak MD, Wichita
Scott Stringfield MD, Wichita
Belinda Vail MD, Kansas City
Hotel The Pre-session: SAM Group Learning and the 2015 KAFP
Annual Meeting are both at the Marriott Hotel, 9100 Corporate
Hills Dr., Wichita, KS. The convention room rate is $112 for a single/
double plus applicable taxes. Reservations must be received on or
before 6 pm, May 27, 2015. Reservations will be accepted based on
a space- and rate-available basis at the KAFP group rate after this
date. Call (316) 651-0333 or 1-800-228-9290 and mention that you
are with the KAFP.
CME Offered: Earn up to 28.25 total credits!
Pre-session: SAM Group Learning on June 10, 2015. The American
Board of Family Medicine awards 12 credits to diplomates upon
completion of the group study and the clinical simulation.
Annual Meeting: This live activity, KAFP 2015 Annual Meeting, with a
beginning date of June 11, 2015, has been reviewed and is acceptable for up to 13.25 Prescribed credits by the American Academy of
Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The California Academy of Family Physicians is accredited by the
Accreditation Council for Continuing Medical Education to provide
continuing medical education for physicians. ER/LA Opioid REMS:
Achieving Safe Use While Improving Patient Care has been reviewed
and is acceptable for up to 2 Prescribed credits by the American
Academy of Family Physicians.
This live activity, AAFP Chapter Lecture Series: Treating Obesity in
Adult Patients, June 12, 2015, has been reviewed and is acceptable
for up to 1 Prescribed credit by the American Academy of Family
Physicians. Physicians should claim only the credit commensurate
with the extent of their participation in the activity.
Thursday, June
(5.75 credits)
FOCUS
ON11 FAMILY
MEDICINE MEETING SCHEDULE • JUNE 11-13, 2015 • Wichita Marriott Hotel
Wednesday, June 10
Friday, June 12
1 – 5 pm
6 – 7 am
Fun Run/Walk
7:15 – 4
Registration Open
Thursday, June 11
7:15 – 7:45 Breakfast in the Exhibit Hall
8:45 –10 am 7:45 – 8:15
Effective Collaboration with PAs and
APRNs, Lynn Fisher, MD
8:15 – 9:15
AAFP Chapter Lecture Series: Treating
Obesity in Adult Patients, Thomas Kintanar,
MD, FAAFP, DABFM This activity is supported by
Pre-session - SAM Group Learning:
Care of the Vulnerable Elderly, Sheryl Beard, MD
KAFP-Foundation (KAFP-F) Board of Trustees Meeting & Breakfast
11 am – 5 pm Registration & KAFP-F Silent Auction open
11 – 11:30
Break, visit exhibits
an educational grant from Takeda Pharmaceuticals
International, Inc., U.S. Region; Orexigen; and Eisai Inc.
11:15 – 12:15 Lunch with Town Hall Meeting & Legislative Update, Doug Gruenbacher, MD, KAFP President
& Dodie Wellshear, Governmental Liaison
9:15 – 9:45
Break, visit exhibits
12:15 – 12:30 Break, visit exhibits
9:15 – 3:30 KAFP-F Silent Auction
12:30 – 2:30
ER/LA Opioid REMS: Achieving Safe Use While Improving Patient Care, Carol Havens, MD
This educational activity is supported by an independent educational grant from the ER/LA Opioid Analgesic REMS Program Companies (RPC). Please see www.er-la-opioid REMS.com for a listing the member companies. This activity is intended to be fully-complaint with the ER/LA Opioid Analgesic REMS education requirements issued by the US Food & Drug Administration (FDA).
2:30 – 2:45 Functional Abdominal Pain Presentation in a Clinical Setting, Kelsey Berlin, DO
2:45 – 3
What’s New with IUD Contraceptives? Bryson Hollingshead, DO
3 – 3:30
Break, visit exhibits
3:30 – 3:45
Three New USPSTF Guidelines for 2014 you need to know, Jonathan Philippe, MD
3:45 – 4:15
AAFP Update,
Robert Wergin, MD, AAFP President
4:15 – 4:30
Hyertension in Pregnancy: Evidence-Based Guidelines for Clinical Practice, Leah Peterson, MD
4:30 – 5:30
Proximity to Colorado & Legalized Marijuana: One Toke Over the (State) Line, Moderator: Doug Gruenbacher, MD; Panelists: Roger Trotter, MD; Lisa McPherson, JD & Steven Wright MD
5:30 – 6 Bonus session: ICD-10: Hitting the Panic Button! Jen Brull, MD
7 – 9:30
Wine Tasting Fundraiser
9:45 – 11:00 KEYNOTE: The Familiar Physician: Saving your Doctor in the Era of Obamacare, Peter Anderson, MD
11:00 – 11:30
Break
11:30 – 12:15 Culture Change in Pursuit of Team Based
Care and Population Health,
Terry L. Mills, MD
12:15 – 1:10
Lunch & Recognitions
1:10 – 2
Member Meeting & Election
2 – 3
New Guidelines for Cancer Screening,
Gary Doolittle, MD
3 – 3:30
Break, exhibitors leave and KAFP-F
Silent Auction closes at 3:30
3:30 – 3:40
Prize Drawings
3:40 – 4:10
Urology and Men’s Health,
Gretchen Dickson, MD
4:10 –5:10
Focus on PCMH: Panel Discussion,
Moderator, Jen Brull, MD; Panelists: Mike
Munger, MD; Terry L. Mills, MD; Beth Loney,
MD; and Allie Lohrmeyer, MD
Saturday, June 13
7 – 8 am
Presidential Circle Breakfast
7 – 8:15
Breakfast & Child Abuse Investigations,
Terra Frazier, DO
Poster Presentations
8:15 – 9
TRACK A:
*9 – 9:30
Pediatric GERD & Nocturnal Enuresis, Robin Walker, MD
*9:30– 10
Breastfeeding Basics, Tracy Williams, MD
10 – 10:15 Break
*10:15 – 11:15 Essential Skills & Tools You Need to Recognize Developmental Problems,
Pam Shaw, MD Track B:
*9 – 9:15
All You Need to Know About FOAMed, Matthew Downen, MD
*9:15 – 9:30 ADHD Treatment Expectations & Frustrations, Charles Armstrong, DO
*9:30 – 9:45
Encopresis Treatment & Prevention, John Moultrie, MD
*9:45 – 10
Etiology & Treatment of Motion
Sickness, Candice Coffey, MD
10 – 10:15 Break
*10:15 – 10:30 What’s New in HIV: Screening and
Pre-exposure Clinical Guidelines, Sara Lowery, MD
*10:30 – 10:45 Asthma Screening and Treatment in a Hospitalized Patient,
Emily Heronemus, DO
*10:45 – 11
Molar Pregnancy: A Case Study,
Danielle Wurtz, DO
*11:00 – 11:15 Ankyloglossia in a Newborn,
Rachael Svaty, MD
Track C:
*9 – 11:15 Track C: Student Workshop: Latex
to Laryngoscopy, Jen Brull, MD
Closing Plenary:
11:15 – Noon
What I Learned at the KAFP Meeting This Year, Rick Kellerman MD
5:10
Check out KAFP-F Silent Auction items
6:30 -7:30
Reception (Photo Booth 6:30-8:30)
12:15 – 2:30 pm Board of Directors Working Lunch and Summer Board Meeting
7:30 – 9:30 President’s Dinner
* Concurrent sessions 2015 Annual Meeting Supporters (as of 03/11/15): Blue Cross Blue Shield of Kansas (Fun Run) | KaMMCO (Tote Bags) | Kansas Chapter,
American Academy of Pediatrics (Educational Grant) | Kansas Foundation for Medical Care (Tote Bags) | The RE-POWER Trial (Rural Engagement in Primary Care for Optimizing Weight Reduction) and Frontiers, Heartland Institute for Clinical and Translational Research (President’s
Dinner & Reception – partial) | University of Kansas Medical Center (Refreshment Break and Tote Bags) | United Methodist Health Ministry
Fund (Educational Grant) | Wichita Nephrology Group, P.A.
Dear Friends,
Please join us at the 2015 KAFP Annual Meeting
“Focus on Family Medicine” June 11-13 at the
Wichita Marriott Hotel. This 3-day event is the
highlight of the year for family doctors from all
parts of the state to meet, enjoy fellowship and earn CME. We are
pleased to offer a June 10 Pre-session: SAM Group Learning. We
have lots of great activities and CME planned. Whether near or far,
rural or urban, I hope each of you will join us to focus on family
medicine!
Sincerely,
Doug Gruenbacher, MD, President
Professional Development
Committee
Chair, Beth Loney Oller MD, Stockton
Committee Members:
Ron Brown MD, Wichita
Sandra Archer MD, Leawood
Sheryl Beard MD, Andover
Jen Brull MD, Plainville
Eric Clarkson DO, Pratt
Kari Clouse MD, Augusta
Carolyn Gaughan, Executive Dir.
Michael Kennedy MD, Lenexa
Joshua Plank MD, Kansas City
THANK
YOU
Scott Rempel, Salina
Aaron Sinclair MD, Wichita
Margaret Smith MD, Kansas City
Diane Steere MD, Wichita
Mark Stovak MD, Wichita
Scott Stringfield MD, Wichita
Belinda Vail MD, Kansas City
Hotel The Pre-session: SAM Group Learning and the 2015 KAFP
Annual Meeting are both at the Marriott Hotel, 9100 Corporate
Hills Dr., Wichita, KS. The convention room rate is $112 for a single/
double plus applicable taxes. Reservations must be received on or
before 6 pm, May 27, 2015. Reservations will be accepted based on
a space- and rate-available basis at the KAFP group rate after this
date. Call (316) 651-0333 or 1-800-228-9290 and mention that you
are with the KAFP.
CME Offered: Earn up to 28.25 total credits!
Pre-session: SAM Group Learning on June 10, 2015. The American
Board of Family Medicine awards 12 credits to diplomates upon
completion of the group study and the clinical simulation.
Annual Meeting: This live activity, KAFP 2015 Annual Meeting, with a
beginning date of June 11, 2015, has been reviewed and is acceptable for up to 13.25 Prescribed credits by the American Academy of
Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The California Academy of Family Physicians is accredited by the
Accreditation Council for Continuing Medical Education to provide
continuing medical education for physicians. ER/LA Opioid REMS:
Achieving Safe Use While Improving Patient Care has been reviewed
and is acceptable for up to 2 Prescribed credits by the American
Academy of Family Physicians.
This live activity, AAFP Chapter Lecture Series: Treating Obesity in
Adult Patients, June 12, 2015, has been reviewed and is acceptable
for up to 1 Prescribed credit by the American Academy of Family
Physicians. Physicians should claim only the credit commensurate
with the extent of their participation in the activity.
Registration provides CME, including credit reported by KAFP for each KAFP member; online
handouts; Internet connection; access to exhibits; refreshments; opportunity to enter prize
drawings; and meals (including 2 complimentary tickets to the President’s Dinner).
Secure online registration is available at http://www.kafponline.org
REGISTRATION
1. Information
7570 W. 21st St. N. #1046C
Wichita, Kansas 67205
SAM Group Learning Session: June 10, 2015, 1-5 pm
2015 KAFP Annual Meeting: June 11-13
Wichita Marriott Hotel
Name:
Print as it should appear on badge. John Smith, MD, FAAFP (example)
Guest:
Address:
City/Zip:
CME
Earn up to
28.25 total
credits
Phone: E-mail:
5. Dietary Needs
2. Meeting Registration: Please CIRCLE membership type and full conference or day(s)
you plan to attend below.
MEMBERSHIP
TYPE
Indicate special dietary need or food allergy:
THURSDAY
ONLY
FRIDAY ONLY
SATURDAY
ONLY
Active Member
$290
$155
$155
$155
Life Member
$115
$65
$65
$65
Resident Member
No charge
No charge
No charge
No charge
6. Payment
Student Member
No charge
No charge
No charge
No charge
Non-Member Physician
$340
$175
$175
$175
Allied Health Professionals
$165
$90
$90
$90
$ ______ Registration TOTAL
$ ______ Additional Activity/Contribution TOTAL
$ ______ Late Fee: $35 after June 1
_______________________________________
REGISTRATION TOTAL $
3. Meals, Activities, Contributions: Please indicate how many persons for each meal/activity.
DATE
Sneak Peak....FOCUS on these Highlights
Wed., June 10
WEDNESDAY
Pre-session: SAM Group Learning: Care of the Vulnerable Elderly,
June 10, 2015, 1-5 pm at the Marriott Hotel, Wichita, KS. Additional registration fee applies.
THURSDAY
Town Hall: Our first Annual Meeting focus is on the Town Hall Meeting and
Legislative Update. Enjoy lunch and interact with leaders.
Support KAFP-Foundation: The KAFP-F Silent Auction will be open Thurs-Fri.
There will be a variety of interesting items to bid on and it is for a worthy cause!
You are also invited to attend the popular Wine Tasting Fundraiser Thursday
evening, a charity event in the home of Dr. Sheryl Beard and Mr. Steve Johnson.
All proceeds benefit the KAFP-Foundation. The evening includes a live auction of
wines! Light hors d’œuvres will be served. You may wish to eat before, as this will
not be a full meal.
FRIDAY
Fun Run/Walk: Focus on good health bright and early at the KAFP Fun Run/Walk.
Keynote: Peter Anderson, MD will present The Familiar Physician: Saving your Doctor in the Era of Obamacare.
Member Meeting: Elect your 2015-16 officers. Special award and scholarship recipients will be honored.
President’s Dinner: Recognize the 2015 Kansas Family Physician of the Year. See your new officers installed, including Diane Steere,
MD of Wichita as your 2015-16 president.
SATURDAY
Poster Contest: Learn from and be inspired by residents and medical students!
Tracks: An interactive student workshop, a peds track and short 15 minute presentations by residents will keep you captivated. The
meeting will close at noon following a plenary wrap-up session.
__________________________________________
FULL CONFERENCE
EVENT
NUMBER
Pre-session:
SAM Group Learning:
Care of the Vulnerable Elderly
FEE
MY FEE
$150 for $
Members/
$250 Nonmembers
Thurs., June 11
Lunch
Thurs., June 11
Wine Tasting Fundraiser to benefit
the KAFP-Foundation. Tax deductible
contribution. (optional)
$75/ticket $ Roundtrip shuttle service from
Marriott Hotel to Wine Tasting
$5/person
No charge
________________________________________
$ ______ TOTAL PAYMENT
p CHECK ENCLOSED (payable to KAFP)
pVISA pMASTERCARD pDISCOVER
Card # ________________________________
______________________________________
Exp. Date: ___________CVS Code___________
Name as it appears on card:(Please Print)
______________________________________
Fri., June 12
Fun Run/Walk participant(s)
Indicate t-shirt size(s)__________
No charge
Fri., June 12
Continental Breakfast
No charge
Fri., June 12
Member Meeting Lunch
No charge
Fri., June 12
President’s Dinner- 2 complimentary
No charge
Fri., June 12
Additional President’s Dinner tickets
$75/ticket $
Billing Address/City/State/Zip:
______________________________________
______________________________________
______________________________________
Signature: _____________________________
Thank You.
Sat., June 13
Presidential Circle Breakfast
(for officers and past Presidents)
No Charge
Sat., June 13
Breakfast
No charge
Sponsor a medical student Tax deductible contribution.
Printed copy of handouts (Handouts will be available online prior
to conference. Wireless Internet connection will be available.) $100/each $
$50/printed $
handouts
ADDITIONAL ACTIVITY / CONTRIBUTION TOTAL $
RETURN WITH PAYMENT OR CALL:
Kansas Academy of Family Physicians
7570 W. 21st St. N. #1046C, Wichita, KS 67205
316.721.9005 | 800.658.1749 | fax 316.721.9044
CANCELLATION POLICY: Written requests for
cancellation will be refunded less a $35 administrative fee if received no later than June
1, 2015. Later cancellations and no-shows are
not eligible for a refund.