November 9–11, 2018 Memorial Union-Arizona State UniversityTempe, Arizona

Register Online Today!

Advancing Medicine: New Perspectives on Established PracticesThis live activity has been designated for 12.75 CME credits and 12.75 MOC points. An additional 4 CME credits can be obtained by participating in the SEP modules precourse.

Arizona Chapter Scientific Meeting 2018

Meeting Highlights

• Two SEP modules• Medical Student and Resident Poster

Competitions• Doctor’s Dilemma®

• Updates in Hypertension Management and Palliative Care

• Translational Science and the Road to New Treatments

• The Role and Value of Hospitalists

Dear Colleague,

Join me and your colleagues in internal medicine at the next scientific meeting of the Arizona Chapter of the American College of Physicians, being held November 9–11, 2018, at the Memorial Union–Arizona State University in Tempe.

The meeting is a great way for you to recharge, rewind, and reflect with your peers, chapter leaders, and great speakers. Connect with the Arizona Chapter’s rich source of knowledge content and networking by attending our premier meeting for general internists, subspecialty internists, hospitalists, allied health practitioners, residents, and medical students.

In addition to earning CME credits, this conference is about making personal contacts and getting involved in your chapter. You’ll engage with people who know your challenges and can help you find solutions. The opportunities available at this meeting will help you meet not only your needs as a physician, but also the needs of the patients you serve.

To ensure your place at this invaluable meeting, register now by visiting us online at azchapter.acponline.org.

I look forward to seeing you in Tempe!

Sincerely,

Robert M. Aaronson, MD, FACPACP Governor, Arizona Chapter

Schedule at a Glance

Friday, November 9, 201811:00 a.m.Faculty Development Registration11:00Welcome and IntroductionsRobert M. Aaronson, MD, FACP Governor, ACP Arizona Chapter

Mark A. Zubriski, PhD, MD, FACP 2018 Program Chair

11:30 Lunch (buffet) 11:55 Faculty Medical Education Consortium Luncheon—Advancing Medicine: New PerspectivesOpen to all Meeting Attendees with Advance Registration

Keynote Speaker: Parminder Singh, MD

Immunotherapy: The Role of the Hospitalist in the Recognition and Treatment of Side Effects12:55 p.m.Q&A 1:10 Controversies: Decoding Confusing Guidelines—Practical Management of HypertensionShakaib UR Rehman, MD, FACP, FAACH

2:10Q&A

Medical Student and Resident/Fellow Tracks1:30-2:30Medical Student and Resident/Fellow RegistrationMedical Students Track2:00–3:15What Is an Internist? Meet the Residency DirectorsHost: Allan L. Markus, MD, MS, MBA, FACP

Medical Students meet and pose questions to Program Directors from all Arizona Internal Medicine Residency Programs.

Janis E. Blair, MD, FACP, Mayo Clinic Arizona Jaya M. Raj, MD, FACP, St Joseph’s Hospital and Medical Center William G. Elliott, DO, FACC, FACOI, FACP, Canyon Vista Medical Center Allan L. Markus, MD, MS, MBA, FACP, HonorHealth Thompson Peak Medical Center Laura Meinke, MD, FACP, FCCP, UACOM @ University Campus Cheryl O’Malley, MD, FACP, UACOM-Phoenix Yamine Saddouk, DO, MD, Mountain Vista Medical Center Shannon E. Skinner, MD, FACP, FAAP, Maricopa Medical Center Eugene A. Trowers, Jr., MD, MPH, FACP, UACOM, South Campus

Residents Track–Meet in Exhibit Hall2:30–3:15 Preparing for Fellowship and/or Clinical Practice 3:15–3:30 Networking Break/Visit Exhibitors/View Posters Refreshments Served

3:15–3:30 Session 1 Poster Judges Assemble

Advancing Medicine: New Perspectives on Established Practices

Schedule at a Glance3:30–5:30Session 1: Medical Students and Resident/ Fellow Members Poster Judging–Exhibit Hall Refreshments Served in Exhibit Hall

5:30–6:15Doctor’s Dilemma® Medical Student RoundModerator: Avtar Singh, MD, FACP Co-Moderator: Mark A. Zubriski, MD, PhD, FACP Medical Student Team Winner will be determined. Team members listed following the Sunday program.

6:30–7:00Social Time 7:00–9:00Governor’s Dinner Robert M. Aaronson, MD, FACP

Laughter in Medicine Carrie A. Horwitch, MD, MPH, FACP

Saturday, November 10, 20187:00 a.m.Registration Opens7:00 Governor’s Advisory Council Members-Only Breakfast7:00–8:00Continental Breakfast8:00 Governor’s WelcomeProgram Chair Welcome and IntroductionsRobert M. Aaronson, MD, FACP Governor, ACP Arizona Chapter

Mark A. Zubriski, PhD, MD, FACP 2018 Program Chair

8:10 Keynote Address: Introduced by Chapter Governor, Robert M. Aaronson, MD, FACP

Patient’s Needs, Translational Science, and the Road to New Treatments: A Personal JourneyGuy L. Reed, III, MD, MS

9:10Healthcare Challenges and Solutions: ACP Advocacy in ActionPatients Over Paperwork: Advocating for Physician Well-beingChelsea J. McGarvey, MD Priya Radhakrishnan, MD, FACP

10:00 Networking Break/Visit Exhibitors/View Posters Exhibit HallRefreshments Served

10:30–11:50 Panel: Palliative Care Moderator: Mark A. Zubriski, MD, PhD, FACP

10:30 Scope of Palliative Care in Heart FailureMasood A. Kisana, MD, FACP

11:05 Controversies: Unusual Cases that Need AnswersPaul E. Stander, MD, MBA, FACP

11:40–11:50Q&A11:50 Lunch Take advantage of opportunities to visit exhibitors and join “Roundtables” for mentoring fun.12:40–2:15 p.m.Panel: Challenges and Solutions Moderator: Eugene A. Trowers, Jr., MD, MPH, FACP

12:40–1:30Challenge #1: Promises and Challenges for GI in 21st CenturyMichele Young, MD

1:30–2:15Challenge #2: Patient-Centered Innovation for Kidney DiseasePrabir Roy-Chaudhury, MD, PhD

2:05 Session 2: Poster Judges AssembleMark A. Zubriski, MD, PhD, FACP

2:20–3:45Networking Break/Visit Exhibitors/View PostersRefreshments Served in Exhibit Hall

Schedule at a Glance2:20–3:45Session #2: Medical Students and Resident/ Fellow Members Poster Competition3:45 Introduction by Anita C. Murcko, MD, FACP

Behavioral Health Integration is Mostly About Enhanced Primary Care and Has Little to Do With Mental HealthRodger S. Kessler, PhD, ABPP

4:15 Introduction by Richard D. Gerkin, MD, MS, FACP, FACMT

AnaphylaxisHugh L. Mackechnie, MD

4:45Doctor’s Dilemma® Team Check-in5:00–6:15Doctor’s Dilemma® Residents’ Preliminary RoundModerator: Mark A. Zubriski, MD, PhD, FACP Co-Moderator: Avtar Singh, MD, FACP Refreshments Served in Exhibit Hall

Sunday, November 11, 20187:00 a.m.Registration7:00–8:00Coffee for early risers8:00 Governor’s WelcomeProgram Chair Welcome and Introductions Robert M. Aaronson, MD, FACP Governor, ACP Arizona Chapter

Mark A. Zubriski, MD, PhD, FACP 2018 Program Chair

8:10 Keynote AddressIntroduction by Robert M. Aaronson, MD, FACP, ACP Arizona Chapter Governor

The Fourth Aim: Improving How Physicians Thrive at Work Carrie A. Horwitch, MD, MPH, FACP

9:10 Networking Break/Visit Exhibitors/View PostersRefreshments available

9:20 Oral Vignettes PresentationsModerator: Hamed Abbaszadegan, MD, MBA, FACP

9:22 UACOM @ University Campus 9:33 UACOM–Phoenix 9:44 UACOM–South 9:55 Maricopa Medical Center 10:06 St. Joseph’s Hospital and Medical Center 10:17 Canyon Vista Medical Center 10:28 Verde Valley Medical Center 10:39 Mayo Clinic Arizona 10:50 HonorHealth

11:05 Break 11:05–11:20Doctor’s Dilemma® Teams Check-in11:20Doctor’s Dilemma® Final RoundModerator: Avtar Singh, MD, FACP Co-Moderator: Mark A. Zubriski, MD, PhD, FACP

12:05 p.m.Awards/Concluding Remarks/AdjournmentChapter Awards Cheryl W. O’Malley, MD, FACP, Awards Chair

Presentation of Laureate AwardRobert M. Aaronson, MD, FACP Governor, Arizona Chapter ACP

Awards Presentations: Posters, Oral Vignettes, and Doctor’s Dilemma®Hamed Abbaszadegan, MD, MBA, FACP Avtar Singh, MD, FACP Mark A. Zubriski, MD, PhD, FACP

Concluding RemarksPriya Radhakrishnan, MD, FACP Governor-elect, ACP Arizona Chapter

Robert M. Aaronson, MD, FACP Governor, ACP Arizona Chapter

Mark A. Zubriski, MD, PhD, FACP 2018 Program Chair

Meeting Information

Robert M. Aaronson, MD, FACP, FCCP, FAASM, ACP Governor, Arizona Chapter; Director of Medical Education, Tucson Medical Center, Tucson; Clinical Professor of Medicine, University of Arizona and Midwestern University; Adjunct Professor, A.T. Still University, Tucson

Hamed Abbaszadegan, MD, MBA, FACP, 2016 Chapter Meeting Program Chair; Chief Health Innovation & Informatics Officer, Phoenix VA Health Care System; Clinical Assistant Professor of Biomedical Informatics and Internal Medicine University of Arizona College of Medicine–Phoenix, Phoenix

Janis E. Blair, MD, FACP, Professor of Medicine; Program Director, Internal Medicine Residency; Consultant, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix

Sai-Sridhar Boddupalli, MD, St Joseph’s Hospital and Medical Center, Phoenix

William G. Elliott, DO, FACC, FACOI, FACP, Director of Medical Education, CVMC Internal Medicine Residency Program, Director, Canyon Vista Medical Center, Sierra Vista

Timothy C. Fagan, MD, FACP, 2011 Chapter Meeting Program Chair; 2015 Arizona ACP Chapter Laureate; Professor of Internal Medicine Emeritus, University of Arizona College of Medicine, Tucson

Eric P. Gall, MD, MACP, MACR, 2015 Chapter Meeting Program Chair; Emeritus Professor of Medicine (Rheumatology), University of Arizona, Tucson; Emeritus Professor and Past Chair, Department of Medicine, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, IL

Richard D. Gerkin, MD, MS, FACP, FACMT, Clinical Associate Professor of Medicine, University of Arizona College of Medicine Phoenix; Medical Director, Graduate Medical Education, Banner University Medical Center, Phoenix

Carrie A. Horwitch, MD, MPH, FACP, Key Clinical Faculty, Virginia Mason Medical Center; Clinical Associate Professor, University of Washington, Seattle, WA

Paul F. Howard, MD, MACP, Past Governor, ACP Arizona Chapter; National Director, ACP Arthrocentesis and Bursal Injection Course; Director Arthritis Health, Scottsdale

James F. Keane, DO, MEd, Internist and Assistant Professor, A.T. Still University, Mesa

Rodger S. Kessler, PhD, ABPP, Chair of Research and Evaluation; Professor, Department of Behavior Health Program, Arizona State University; Senior Scientist, National Research Network, American Academy of Family Physicians , Phoenix

Masood A. Kisana, MD, FACP, Deputy Associate Chief of Staff, Geriatrics & Extended Care Services, Phoenix VA Health Care System, U.S. Department of Veterans Affairs; Clinical Assistant Professor of Medicine, University of Arizona College of Medicine, Phoenix

Helene R. Labonte, DO, FACP, 2014 Chapter Meeting Program Chair; Consultant, Community Internal Medicine; Assistant Professor of Medicine, Mayo Clinic Arizona

Hugh L. Mackechnie, MD, Practicing Allergist and Immunologist, Scottsdale

Allan L. Markus, MD, MS, MBA, FACP, 2009 Chapter Meeting Program Chair; Internal Medicine Residency Program Director, HonorHealth; Clinical Associate Professor of Medicine, Univer-sity of Arizona College of Medicine, Phoenix

Chelsea J. McGarvey, MD, Internal Medicine Specialist, Scottsdale

Laura Meinke, MD, FACP, FCCP, Program Director, Internal Medicine/Pulmonary and Critical Care Medicine, University of Arizona College of Medicine at University Campus, Tucson

Kevin F. Moynahan, MD, FACP, 2009 Chapter Meeting Program Chair; Deputy Dean for Education; Director, Societies Program; Professor of Medicine, University of Arizona College of Medicine, Tucson

Anita C. Murcko, MD, FACP, Clinical Associate Professor, Department of Biomedical Informatics, Arizona State University; Faculty, Mayo Clinic College of Medicine; University of Arizona Health Sciences Center, College of Pharmacy; President and CEO, Cambiare, LLC, Scottsdale

Cheryl W. O’Malley, MD, FACP, Program Director, University of Arizona College of Medicine-Phoenix Internal Medicine Residency Program; Associate Professor of Medicine, University of Arizona College of Medicine, Phoenix

Jayne M. Peterson, MD, FACP, 2012 Chapter Meeting Program Chair; Associate Program Director, University of Arizona College of Medicine Phoenix Internal Medicine Residency, Associate Professor of Medicine, University of Arizona College of Medicine, Phoenix

Priya Radhakrishnan, MD, FACP, Governor-elect, ACP Arizona Chapter ; Member, Clinical Informatics Committee, ACP; Chief Academic Officer, HonorHealth; Physician Advisor, Practice Innovation Institute, Scottsdale

Jaya M. Raj, MD, FACP, Internal Medicine Residency Program Director, St Joseph’s Medical Center; Professor of Medicine Creighton University School of Medicine; Associate Professor of Medicine, University of Arizona College of Medicine, Phoenix

Shakaib U. Rehman, MD, FACP, FAACH, Associate Chief of Staff for Education, Phoenix VA Health Care Systems; Profes-sor and Chair of Biomedical Informatics & Professor of Internal Medicine, University of Arizona College of Medicine, Phoenix

Prabir Roy-Chaudhury, MD, PhD, Professor of Medicine, The University of Arizona Health Sciences; Director, Division of Nephrology, Director, Arizona Kidney and Vascular Center at the University of Arizona College of Medicine, Tucson

Faculty

Yamine Saddouk, DO, MD, Internal Medicine Program Director, Mountain Vista Medical Center, Mesa

Avtar Singh, MD, FACP, Academic Hospitalist Phoenix VA Healthcare Systems; Clinical Assistant Professor, University of Arizona COM, Phoenix

Parminder Singh, MD, Senior Oncologist, Hematologist and Internist at Mayo Clinic, Scottsdale

Shannon E. Skinner, MD, FACP, FAAP, Internal Medicine Residency Program Director, Maricopa Integrated Health System, Phoenix

Paul E. Stander, MD, MBA, FACP, Geriatrician, Phoenix VA Health Care System, U.S. Department of Veterans Affairs, Phoenix

Eugene A. Trowers, Jr., MD, MPH, FACP, 2017 Chapter Meeting Program Chair; Professor of Medicine, Program Director Internal Medicine Residency and Director of GI Services, University of Arizona Medical Center–South Campus, Tucson

Rupal S. Vora, MD, FACP, 2013 Chapter Meeting Program Co-Chair; Assistant Dean of Student Achievement; Associate Professor, Internal Medicine; A.T. Still University, School of Osteopathic Medicine, Mesa

Michele Young, MD, gastroenterologist, Phoenix VA Health Care System, U.S. Department of Veterans Affairs, Phoenix

Mark A. Zubriski, MD, PhD, FACP, 2018 Chapter Meeting Program Chair; Academic Hospitalist, Phoenix VA Health Care System, U.S. Department of Veterans Affairs; Clinical Assistant Professor, University of Arizona College of Medicine, Phoenix

Program CommitteeMark A. Zubriski, MD, PhD, FACP, 2018 Program Chair

Robert M. Aaronson, MD, FACP, Arizona Chapter Governor

Hamed Abbaszadegan, MD, MBA, FACP

Timothy C. Fagan, MD, FACP

Eric M. Gall, MD, MACP, MACR

Paul F. Howard, MD, MACP

James Keane, DO, MEd

Helene R. Labonte, DO, FACP

Alln L. Markus, MD, MS, MBA, FACP

Laura Meinke, MD, FACP, FCCP

Kevin F. Moynahan, MD, FACP

Anita C. Murcko, MD, FACP

Priya Radhakrishnan, MD, FACP

Jaya Raj, MD, FACP

Shakaib U. Rehman, MD, FACP, FAACH

Avtar Singh, MD, FACP

Eugene A. Trowers, Jr., MD, MPH, FACP

Rupal S. Vora, MD, FACP

Mark A. Zubriski, MD, PhD, FACP

Joni Bowers, Posters and Doctor’s Dilemma® Leadership

Dixie S. Swan, MA, Executive Director

Meeting Information

Meeting Information

Learning ObjectivesAt the conclusion of this activity, the participant will be able to:

• Apply updated knowledge of hypertension management and patient-centered innovation for kidney disease to clinical practice.

• Understand recent advances in physician self-care and thriving at work.

• Diagnose and manage anaphylaxis.

• Understand the scope of palliative care in heart failure.

Who Should Attend? • General internists

• Subspecialty internists

• Family practitioners

• Fellows in subspecialty training

• Hospitalists

• Allied health practitioners

• Residents

• Medical students interested in internal medicine

Chapter AwardsThe Arizona Chapter presents will be presenting the following Chapter awards:

Laureate Award Volunteerism and Community Service Award Early Career Physician Award Educator of the Year Award Hospitalist of the Year Award Internist of the Year Award Leader of the Year Researcher of the Year Resident/Fellow of the Year Medical Student of the Year

Please join us on Sunday, November 11, 2018, at 12:05 p.m. for Awards presentations.

CME Accreditation and MOC PointsThe American College of Physicians (ACP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The ACP designates each live activity for the number of AMA PRA Category 1 Credit(s)TM listed below. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Arizona Chapter Scientific Meeting for a maximum of 12.75 AMA PRA Category 1 Credit(s)TM.

The SEP modules precourse, for a maximum of 4 AMA PRA Category 1 Credit(s)TM.

Successful completion of this CME activity (the Arizona Chapter Scientific Meeting), which includes participation in the evaluation component, enables the participant to earn up to 12.75 medical knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Resident/Fellow Members’ ActivitiesClinical vignettes, posters, and research papers prepared by Resident/Fellow Members will be presented at the meeting. Winners will receive $150 for first place, $100 for second place, and $50 for third place. Winners of the Resident/Fellow Research Poster and Oral Vignette will be eligible for entrance into the National ACP Poster Competition, and will receive a $1000 stipend to attend Internal Medicine Meeting 2019 in Philadelphia, PA. Contact Dixie Swan at dswan@azmed.org for information about entering the competition. Deadline for submissions is September 8, 2016.

• Friday: Speak with Fellowship Directors, one-on-one, in a special Residents’ track

• Saturday and Sunday: Doctor’s Dilemma® competition. Winning team members will receive $150 each and a $1000 stipend to attend IM 2019 in Philadelphia, Pennsylvania.

Medical Student Activities• Face and question a panel of Residency Program

Directors from programs all over the state

• Doctor’s Dilemma® Medical Student Round

• Medical Student Poster Competition: $150 for first place, $100 for second place, and $50 for third place.

Maintenance of Certification

Friday, November 9, 20187:00 a.m. Registration and Continental Breakfast for ABIM SEP Modules Attendees7:30–9:30 2018 Hospital Medicine Update Instructors: Misty V. Evans, MD and Evan Holdsworth, MD

9:40–11:40 2018 Internal Medicine Update Instructor: Nacchal Nachiappan, MD

SEP FacultyMisty V. Evans, MD, Internist, Affiliated Hospitalists, PLC at HonorHealth Scottsdale Thompson Peak Medical Center, Scottsdale

Evan Holdsworth, MD, Internist, HonorHealth, Phoenix

Nacchal Nachiappan, MD, Internist, Phoenix VA Health Care System, U.S. Department of Veterans Affairs, Phoenix

SEP Learning Objectives• Participate in group discussion to determine answers

to multiple-choice questions.

• Apply updated knowledge of internal medicine to clinical practice.

• Understand recent advances in internal medicine.

• Complete an ABIM SEP Module toward partial fulfillment of the ABIM’s Maintenance of Certification.

SEP CME Accreditation The American College of Physicians is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American College of Physicians designates this live activity for a maximum of 4 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Who Should Attend the SEP Precourse?• Internists participating in the ABIM Maintenance of

Certification Program

• General internists

• Family practitioners

• Subspecialty physicians

SEP NoteThe Arizona Chapter will provide you with a learner’s copy of the ABIM module(s) at the meeting. If you are enrolled in the ABIM’s Maintenance of Certification program, you also must order the module* directly from the ABIM by visiting www.abim.org/online. After the Learning Session, submit your answers online to the ABIM for Maintenance of Certification credit. For more information about the ABIM’s Maintenance of Certification program, visit www.abim.org/moc or call ABIM at 800-441-ABIM (2246).

This module is eligible for 4 MOC points through ABIM.

Precourse: ABIM SEP Modules Session for Maintenance of Certification

*If you are already enrolled in the ABIM Maintenance of Certification program, there is no additional fee for this official version of the module. If you are not enrolled, you may attend the Learning Session; however, you must enroll before receiving Maintenance of Certification points for the knowledge module. To enroll, visit www.abim.org/online.

Additional Information

Satisfaction GuaranteeThe College offers a satisfaction guarantee for all of its courses. If meeting attendees are not satisfied with their experience at a chapter meeting, they may write and request a refund of their registration fee.

Registration InformationLate Registration & On-site Fees All registrations must be received by October 3, 2018, or a late registration fee of $50 will be added. This includes on-site registrations. Save money by registering now!

Cancellations/Refunds Notice of cancellation must be made in writing (fax, mail, or e-mail). Cancellations will not be accepted by telephone. A processing fee of $25 will be deducted from the member’s refund. Individuals who fail to attend the course (no-shows) will not be entitled to any refund.

v BY INTERNET UBY MAIL T BY FAX SBY PHONE(Credit Card only) Make check or money order (Credit Cards only) Call 800-523-1546, ext. 2600,Visit us on the Web payable to ACP. 215-351-2799 or 215-351-2600www.acponline.org/chapters AC002 (M–F, 9 a.m.–5 p.m. ET) American College of Physicians 190 N. Independence Mall West Philadelphia, PA 19106-1572

Hotel AccommodationsWe have reserved a block of rooms at the following hotels until October 3, 2018. When making your reservation, be sure to mention that you will be attending the ACP Arizona Chapter meeting. The rooms are available on a first-come, first-served basis, so make your reservation as early as possible.

Tempe Mission Palms Hotel 50 East Fifth Street Tempe, AZ

Make your reservation by this direct booking link: https://gc.synxis.com/rez.aspx?Hotel=12318&Chain= 15564&promo=ASUNEGMP

Event name: ACP-AZ

King or Double/Queen: Room Rate: $164 plus tax

Best Western Inn of Tempe 670 N. Scottsdale Road Tempe, AZ

Make your reservation by calling 480-784-2233

Event name: ACP-AZ

King: $99.99 plus tax Double/Queen: $109.99 plus tax

Directions/ParkingLong-term visitor parking is available at the Apache Boulevard Parking Structure, 300 East Lemon Street, Tempe, Arizona, at Arizona State University. For an interactive guide/map, please visit: https://eoss.asu.edu/mu/about/directions.

The Memorial Union at Arizona State University is located at 301 East Orange Street, Tempe, Arizona (directly North of the Apache Boulevard Parking Structure). For more information about the Memorial Union, visit https://eoss.asu.edu/mu/about/directions.

Registration/check-in and the educational sessions for the ACP Arizona Chapter will be held on the Second Level of the Memorial Union, in the hallway outside of the Arizona Ballroom. For a map of the Second Level of the Memorial Union, visit https://eoss.asu.edu/sites/default/files/secondFloor_emsFeatures.pdf

Contact Us

Arizona Chapter Registration Form CMB

ACP # (found on mailing label)

Name □ MD □ DO □ OTHER

Address

City State ZIP

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□ Please check here to indicate a permanent change to your preferred address for all College mailings.

□ Please exclude me from receiving mailings from the meeting exhibitors.

□ Check here if you are disabled and require assistance. Please notify the Arizona Chapter in writing before your course. We’ll be glad to help.X

Registration FeesCheck one category that best applies. Registration fee includes continental breakfasts, lunches, all scientific sessions and materials, and CME documentation.

Categories Register by October 3, 2018 After October 3, 2018 □ ACP Member $225 $275 □ ACP Resident/Fellow Member $25 $25 □ ACP Medical Student Member No fee No fee □ Nonmember Physician $325 $375 □ Nonmember Resident* $25 $25 □ Nonmember Medical Student No fee No fee □ Nonmember Allied Health Professional $325 $375

*Nonmember Residents cannot register online and must register by contacting Customer Service at 800-523-1546, ext. 2600, in order to get the correct registration rate.

Please note: Members whose dues were not paid by July 1 for the current fiscal year will receive the nonmember registration rate.

SEP Module Registration (Continental Breakfast Included) Friday, November 9, 2018

RM1939Tempe, Arizona ● November 9–11, 2018

SEP Module #1: 2018 SEP Module #2: Internal Hospital Medicine Update Medicine 2018 Update SEP Modules #1 and #2 Categories (RM1939A) (RM1939B) (RM1939C) □ ACP Member $75 $75 $150 □ ACP Nonmember $90 $90 $180

□ Will you serve as a judge for the abstract competition?

Arizona Chapter Registration Form CMB

CHS7181

Payment Options

□ Check enclosed. (Payable to ACP. Must remit in U.S. funds drawn on a U.S. bank.)

□ Charge to:

Card # ______________________________________________

Exp. Date ______/______ Security Code _______________ MM/YY (3- or 4-digit number found on front or back of card)

Signature: __________________________________________

Please indicate your attendance at the following:

□ FDLUN—Faculty Development Lunch—Friday, 11:30 a.m.–1:10 p.m.

□ MS—Medical Student Track—Friday, 2:30–3:15 p.m.

□ RES—Resident/Fellow Member Track—Friday, 2:30–3:15 p.m.

□ BANQ—Governor’s Dinner—Friday, 7:00–9:00 p.m.—$90

□ BR01—Continental Breakfast—Saturday, 7:00–8:00 a.m.

□ LUN01—Boxed Lunch—Saturday, 11:50 a.m.–12:40 p.m.

□ LUN01V—Vegetarian Boxed Lunch—Saturday, 11:50 a.m–12:40 p.m. Grand Total $ _______________