registration form - SHPA CPD
Transcription
registration form - SHPA CPD
continuing professional development supporting your lifelong practice as a current, informed and connected health professional Introduction to HIV Workshop Saturday 30 May 2015 – 9.00 am to 5.00 pm (registration commences at 8.30am) Pharmacy Building (A15), Room N351 Science Road, University of Sydney NSW 2006 Program at a Glance This one day program is for all pharmacists who want to have a better understanding of managing people with HIV. With changes to the availability of HIV antiretrovirals from July 2015, these workshops will be particularly valuable to pharmacists with little or no recent experience in dispensing these medicines. Topics include: ■ An overview of HIV infection, viral transmission and disease management ■ HIV medicines including the products available, their modes of action, dosing considerations, managing interactions and adverse events. Individualisation of treatment and clinical monitoring will also be covered. ■ Interactive dispensing- patient adherence and counselling ■ The social, personal and emotional aspects of HIV The program will involve lectures, group discussion and case studies. Pharmacist competency standards* addressed include: 1.2 Practise to accepted standards 1.3 Deliver ‘patient-centred” care 2.1 Communicate effectively 4.1 Undertake initial prescription assessment 4.2 Consider the appropriateness of prescribed medicines 6.3 Contribute to public and preventative health 7.1 Contribute to therapeutic decision-making 7.2 Provide ongoing medication management 7.3 Influence patterns of medicine use * National Competency Standards Framework for Pharmacists in Australia 2010 Speakers Accreditation number: S2015/9 Registration Travel and Accommodation SHPA Contact Details Learning objectives 1. Discuss key aspects of HIV diseases (including life cycle) and its management 2. Discuss the medicines used in treating HIV infections, including their modes of action, dosing considerations, how to manage interactions, adverse events and required clinical monitoring 3. Discuss important aspects of adherence and counselling required in the management of HIV positive patients 4. Discuss the social, personal and emotional aspects of HIV that are important to deliver patient-centred care in managing HIV patients Professor Don Smith, MBBS, FRACP, MD, Infectious Diseases Consultant, Albion Centre, NSW Russell Levy BPharm, Deputy Director of Pharmacy, Royal North Shore Hospital, NSW Damian Fagan BPharm GradDipClinPharm, Senior Pharmacist, Albion Centre, NSW Dianne Carey BPharm MPH PhD, Clinical Project Leader, Kirby Institute UNSW, NSW Sohlileh Aran BPharm Clinical Pharmacist, Royal Prince Alfred Hospital, NSW Sylvia Bridle BPharm, Pharmacy Manager- Outpatients, St Vincent’s Hospital, Darlinghurst NSW HIV positive speaker This activity has been accredited for 5 hours of Group 1 CPD (5 CPD credits) and 1 hour of Group 2 CPD (2 CPD credits) suitable for inclusion in an individual pharmacist’s CPD plan. This comprises a total of 7 CPD credits suitable for inclusion in an individual pharmacist’s CPD plan. The registration fee includes tuition, a comprehensive package of course reference materials, lunches and morning/afternoon teas. Course materials will be available to participants on the day. Participants are requested to make their own arrangements for travel and accommodation AFTER THEY RECEIVE CONFIRMATION OF A PLACE IN THE COURSE. See overleaf for Registration Form The Society of Hospital Pharmacists of Australia ABN 54 004 553 806 Mailing address: PO Box 1774 Collingwood 3066 Victoria Australia Office location: Suite 3, 65 Oxford Street Collingwood 3066 Victoria Australia T: 61 3 9486 0177 F: 61 3 9486 0311 E: [email protected] W: www.shpa.org.au Introduction to HIV Workshop Re g ea iste Saturday 30 May 2015– 9.00 am to 5.00 pm (registration commences at 8.30am) ens rly to r u pla re a ce Pharmacy Building (A15), Room N351 Science Road, University of Sydney NSW 2006 Registration Form Name and Contact Title (Ms/Mr/Dr etc)___________________________________________________________________ Family Name________________________________________________________________________ Given Names________________________________________________________________________ Email Address_______________________________________________________________________ Mailing Address______________________________________________________________________ __________________________________________________________________________________ ______________________________________________State__________ Postcode______________ Telephone B/H ( )________________________Facsimile B/H ( )_________________________ Special Dietary Requirements___________________________________________________________ Current Position______________________________________________________________________ Workplace Employer___________________________________________________________________________ Number of Years Experience in HIV Limited or no experience Registration Fees (name of hospital/institution/company/practice etc) 1-2 years Early Bird Rate Full Rate (register by 1st May 2015) (after 1st May 2015) SHPA Members:$297.00 (includes GST) $330.00 (includes GST) Non-Members: $352.00 (includes GST) $396.00 (includes GST) Tick here to receive a one year complimentary membership of the Australasian Society for HIV Medicine (www.ashm.org.au) and we will pass on your details (name and email) to ASHM. Your details will only be accessed by ASHM for the purposes of processing this request. ASHM does not sell or give away contact details Upon payment of your registration fee, this Registration Form becomes a TAX INVOICE Acknowledgement of registration and a receipt will be forwarded within 6 weeks. If you do not receive acknowledgement, please contact SHPA. Cancellation Policy Cancellations received before 6 weeks prior to the event, will receive a full refund minus a handling fee of $50. Cancellations received between 6 weeks and 1 week prior to the event, will receive an 50% refund of the registration fee. Cancellations received less than 1 week prior to the event will receive NO REFUND. Substitutions can be made at any time. Privacy Policy If you return this invitation by letter, fax or email, the details will be used to process the invitation. SHPA will not disclose the information to anyone other than volunteers or contractors who provide services to us or unless compelled or permitted by law to do so. If you want to know more about our privacy policy and procedures please visit www.shpa.org.au Payment Details TO ENSURE YOUR PLACE, PAYMENT MUST ACCOMPANY REGISTRATION Cheque enclosed (payable to The Society of Hospital Pharmacists of Australia) Please charge my credit card Visa Mastercard (please note Diners or Amex not available) Card No. Cardholder’s Name: (please print)___________________________________ Expiry Date:___________ SHPA Contact Details Signature:____________________________________________________ Date:__________________ Please Mail or Fax Your Registration Form to: The Society of Hospital Pharmacists of Australia ABN 54 004 553 806 PO Box 1774, Collingwood, Victoria 3066 Australia Tel: (03) 9486 0177 Fax: (03) 9486 0311 Email: [email protected] Website: www.shpa.org.au