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
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Saturday 30 May 2015– 9.00 am to 5.00 pm (registration commences at 8.30am)
ens rly to r
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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