2011 Eddie Ferrell Clinic by Virginia Tech Athletics

Eddie Ferrell Memorial Clinic Attn: Katie Baer

Phone: (540) 231-2711 160 Jamerson Athletic Center (0502) Blacksburg, VA 24061 Email: KatieATC@vt.edu — OR —

Fax Completed Registration Form Attn: Katie Baer (540) 231-7335

With fee payment at registration on the day of the event.

Lodging available: A block of rooms have been reserved at Courtyard Marriott (540) 552-5222 on Southpark Drive in Blacksburg, VA ($109+tax, breakfast included) and at the Hilton Garden Inn (540) 552-5005 on Plantation Road in Blacksburg ($95+tax). Mention the Eddie Ferrell Clinic or visit our website for links and on-line reservation codes to these hotels or contact Katie at KatieATC@vt.edu..

CME Credits – M.D.’s:

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Medical Society of Virginia through the joint sponsorship of Lewis-Gale Medical Center CME Organization and the Edward Via College of Osteopathic Medicine. Lewis-Gale Medical Center designates this educational activity for a maximum of nine hours of AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. VCOM Continuing Medical Education Policy

Evaluation data will be compiled and provided to the VCOM Director of Alumni Relations and Continuing Medical Education. Comments

Blacksburg, VA 24061

Mail Completed Registration Form and Fee:

The Edward Via College of Osteopathic Medicine is accredited by the American Osteopathic Association (AOA) to provide continuing medical education for physicians. This program anticipates being approved for nine AOA Category 1-A CME credit hours pending approval by the AOA CCME. Physicians should only claim credit commensurate with the extent of their participation in the activity.

and suggestions regarding program content, location and other program specific details will be considered when planning future activities. Grievances regarding program administration and reporting of AOA CME credits will be handled on an individual basis by the Director of Alumni Relations and Continuing Medical Education, Megan R. Price, at mprice@vcom.vt.edu or 540-231-1190. Participants with grievances that cannot be resolved by the Director will be sent to VCOM administration and then to the AOA CCME.

160 Jamerson Athletic Center (0502)

CME Credits – D.O.’s

Eddie Ferrell Memorial Sports Medicine Clinic

2011 Eddie Ferrell Memorial Sports Medicine Clinic

8TH ANNUAL

Eddie Ferrell Memorial Sports Medicine Clinic

Disclosure Statement

It is the policy of the VCOM Medical Education Department to ensure balance, independence, objectivity, and scientific rigor in all its educational programs.

Friday and Saturday, April 29 & 30, 2011 Edward Via College of Osteopathic Medicine (VCOM) 2265 Kraft Drive Blacksburg, VA 24060

Continuing Education :

NATA: 9.0 CEUs

Pre-Approval for CME Credit is Pending Virginia Tech Sports Medicine is recognized by the NATA Board of Certification, Inc. to offer continuing education for Certified Athletic Trainers. Provider #P3004.

Sponsored by: The Virginia Tech Sports Medicine Association and the Edward Via College of Osteopathic Medicine (VCOM)

Panel Discussion:

Topics to include: PRP in athletics, Sickle Cell testing, Alternate Physician Careers Dr. Mark Rogers, D.O., M.A. Assistant Professor, VCOM Assistant Team Physician, VT

For more information visit one of our websites: www.hokiesports.com/trainers/eddieferrell

VCOM http://www.vcom.vt.edu/cme/ Dr. Francine Anderson, P.T., Ph.D. Associate Dean for Post-Baccalaureate Pre-Med Program, VCOM

➤ Contact, Mailing and Lodging information on other side ➤

Place of Employment: ___________________________________________

For Saturday’s Alumni event info please contact Katie Baer at KatieATC@vt.edu

• New Concepts in Ankle Injuries

❑ No

• Cadaver Lab for Ankle

Are you a Virginia Tech Sports Medicine Alumni-❑ Yes

Occupation:__________________________________________________

Director of Athletic Training and Rehab for Virginia Tech

E-mail: _____________________________________________________________________________________________________________________

Mike Goforth, M.S., A.T.C.

(home): __________________________________________________

• New Concepts in Shoulder Rehabilitation

Telephone Number (office):_ _________________________________________

• New Concepts in Shoulder Surgery

City: __________________________________________________________________________ State: ____________ Zip:______________________

• Cadaver Lab for Shoulder

Mailing Address: _____________________________________________________________________________________________________________

➤ Please fill out one form for each person registering. ➤ Those bringing groups of 8 or more may have free registration for one participant.

Morning topics will include:

❒ Full Course - Professionals - (Friday and Saturday) $150.00 ❒ Full Course - Students (Friday and Saturday) (No CEV/CME Available) $75 ❒ “The Latest in the Concussion Debate” $50.00 Friday night only (Sorry no student discount)

Saturday, April 30th

Name: _________________________________________________________________________________ Credentials: __________________________

We encourage you to take advantage of this great opportunity to share information with fellow colleagues!

• Sponsored Social

include: Baseline testing, BESS testing, Impact testing, SCAT2 exam, force plate testing, Post-concussion symptoms, Return to play decisions, and much more.

Afternoon topics will include:

Clinic Information

The program schedule is subject to change. A complete agenda and materials will be provided to attendees upon arrival at the clinic.

Course Learning Objectives

The goal of our clinic is to provide an opportunity for learning and sharing techniques in managing current issues in athletics. Participants will have the ability to spend time in the state of the art cadaver laboratory at VCOM, where we will be working with prosected cadavers to identify major anatomical structures and injury scenarios that relate to the topics discussed. The lectures and speakers will cover topics related to areas of interest in sports medicine and open discussion for the current issues facing the medical care of our patients.

• “The Latest in the Concussion Debate” – Topics will

Check one:

Dr. Farmer is the director of Sports Medicine at Lewis Gale Physicians at LewisGale Medical Center specializing in sports medicine and general orthopedic surgery. He is board certified in both by the American Board of Orthopedic Surgery and is a consultant and on medical staff at Virginia Tech, Roanoke College and Salem High School. He graduated from Baylor College of Medicine and completed his residency at Wake Forest University.

✃

Sponsored by the Virginia Tech Sports Medicine Association and the Edward Via College of Osteopathic Medicine (VCOM).

James M. Farmer, M.D.

• Cadaver Lab for skull

Cadaver Course & Clinical Symposium:

health professionals.

Please print or type. Complete one registration form for each registrant. Photocopies are acceptable. Include a check made payable to: VTSPSMA

and any other interested allied

Evening topics will include:

April 29-30, 2011 • VCOM, Blacksburg, VA

therapist assistants, physicians

Clinically, he is the ringside physician with the WWE (World Wrestling Entertainment). He treats both musculoskeletal and medical issues of athletic and physically active individuals, covering the spectrum from the professional athlete to the weekend warrior. Being a D.O., he also incorporates OMM (manual medicine) in the care of his patients.

Friday, April 29th

8th Annual Eddie Ferrell Sports Medicine Clinic

physical therapists, physical

Dr. Sampson is an associate professor of Family Medicine/Sports Medicine, director of Primary Care Skills and Family Medicine Clerkships at GAPCOM. He is also the faculty advisor for the Sports Medicine clubs at Georgia Campus.

Times to be announced - see the website below for updates.

FORM

A clinic for athletic trainers,

Michael J. Sampson, D.O., FAOASM

Agenda

R E G I S T R AT I O N

2011 Eddie Ferrell Memorial Sports Medicine Clinic

Tentative Speakers

Please cut and return

Please Join Us for the

Panel Discussion:

Topics to include: PRP in athletics, Sickle Cell testing, Alternate Physician Careers Dr. Mark Rogers, D.O., M.A. Assistant Professor, VCOM Assistant Team Physician, VT

For more information visit one of our websites: www.hokiesports.com/trainers/eddieferrell

VCOM http://www.vcom.vt.edu/cme/ Dr. Francine Anderson, P.T., Ph.D. Associate Dean for Post-Baccalaureate Pre-Med Program, VCOM

➤ Contact, Mailing and Lodging information on other side ➤

Place of Employment: ___________________________________________

For Saturday’s Alumni event info please contact Katie Baer at KatieATC@vt.edu

• New Concepts in Ankle Injuries

❑ No

• Cadaver Lab for Ankle

Are you a Virginia Tech Sports Medicine Alumni-❑ Yes

Occupation:__________________________________________________

Director of Athletic Training and Rehab for Virginia Tech

E-mail: _____________________________________________________________________________________________________________________

Mike Goforth, M.S., A.T.C.

(home): __________________________________________________

• New Concepts in Shoulder Rehabilitation

Telephone Number (office):_ _________________________________________

• New Concepts in Shoulder Surgery

City: __________________________________________________________________________ State: ____________ Zip:______________________

• Cadaver Lab for Shoulder

Mailing Address: _____________________________________________________________________________________________________________

➤ Please fill out one form for each person registering. ➤ Those bringing groups of 8 or more may have free registration for one participant.

Morning topics will include:

Saturday, April 30th

Name: _________________________________________________________________________________ Credentials: __________________________

We encourage you to take advantage of this great opportunity to share information with fellow colleagues!

• Sponsored Social

include: Baseline testing, BESS testing, Impact testing, SCAT2 exam, force plate testing, Post-concussion symptoms, Return to play decisions, and much more.

Afternoon topics will include:

Clinic Information

The program schedule is subject to change. A complete agenda and materials will be provided to attendees upon arrival at the clinic.

Course Learning Objectives

• “The Latest in the Concussion Debate” – Topics will

Check one:

✃

Sponsored by the Virginia Tech Sports Medicine Association and the Edward Via College of Osteopathic Medicine (VCOM).

James M. Farmer, M.D.

• Cadaver Lab for skull

Cadaver Course & Clinical Symposium:

health professionals.

Please print or type. Complete one registration form for each registrant. Photocopies are acceptable. Include a check made payable to: VTSPSMA

and any other interested allied

Evening topics will include:

April 29-30, 2011 • VCOM, Blacksburg, VA

therapist assistants, physicians

Friday, April 29th

8th Annual Eddie Ferrell Sports Medicine Clinic

physical therapists, physical

Times to be announced - see the website below for updates.

FORM

A clinic for athletic trainers,

Michael J. Sampson, D.O., FAOASM

Agenda

R E G I S T R AT I O N

2011 Eddie Ferrell Memorial Sports Medicine Clinic

Tentative Speakers

Please cut and return

Please Join Us for the

Panel Discussion:

Topics to include: PRP in athletics, Sickle Cell testing, Alternate Physician Careers Dr. Mark Rogers, D.O., M.A. Assistant Professor, VCOM Assistant Team Physician, VT

For more information visit one of our websites: www.hokiesports.com/trainers/eddieferrell

VCOM http://www.vcom.vt.edu/cme/ Dr. Francine Anderson, P.T., Ph.D. Associate Dean for Post-Baccalaureate Pre-Med Program, VCOM

➤ Contact, Mailing and Lodging information on other side ➤

Place of Employment: ___________________________________________

For Saturday’s Alumni event info please contact Katie Baer at KatieATC@vt.edu

• New Concepts in Ankle Injuries

❑ No

• Cadaver Lab for Ankle

Are you a Virginia Tech Sports Medicine Alumni-❑ Yes

Occupation:__________________________________________________

Director of Athletic Training and Rehab for Virginia Tech

E-mail: _____________________________________________________________________________________________________________________

Mike Goforth, M.S., A.T.C.

(home): __________________________________________________

• New Concepts in Shoulder Rehabilitation

Telephone Number (office):_ _________________________________________

• New Concepts in Shoulder Surgery

City: __________________________________________________________________________ State: ____________ Zip:______________________

• Cadaver Lab for Shoulder

Mailing Address: _____________________________________________________________________________________________________________

➤ Please fill out one form for each person registering. ➤ Those bringing groups of 8 or more may have free registration for one participant.

Morning topics will include:

Saturday, April 30th

Name: _________________________________________________________________________________ Credentials: __________________________

We encourage you to take advantage of this great opportunity to share information with fellow colleagues!

• Sponsored Social

include: Baseline testing, BESS testing, Impact testing, SCAT2 exam, force plate testing, Post-concussion symptoms, Return to play decisions, and much more.

Afternoon topics will include:

Clinic Information

The program schedule is subject to change. A complete agenda and materials will be provided to attendees upon arrival at the clinic.

Course Learning Objectives

• “The Latest in the Concussion Debate” – Topics will

Check one:

✃

Sponsored by the Virginia Tech Sports Medicine Association and the Edward Via College of Osteopathic Medicine (VCOM).

James M. Farmer, M.D.

• Cadaver Lab for skull

Cadaver Course & Clinical Symposium:

health professionals.

Please print or type. Complete one registration form for each registrant. Photocopies are acceptable. Include a check made payable to: VTSPSMA

and any other interested allied

Evening topics will include:

April 29-30, 2011 • VCOM, Blacksburg, VA

therapist assistants, physicians

Friday, April 29th

8th Annual Eddie Ferrell Sports Medicine Clinic

physical therapists, physical

Times to be announced - see the website below for updates.

FORM

A clinic for athletic trainers,

Michael J. Sampson, D.O., FAOASM

Agenda

R E G I S T R AT I O N

2011 Eddie Ferrell Memorial Sports Medicine Clinic

Tentative Speakers

Please cut and return

Please Join Us for the

Panel Discussion:

Topics to include: PRP in athletics, Sickle Cell testing, Alternate Physician Careers Dr. Mark Rogers, D.O., M.A. Assistant Professor, VCOM Assistant Team Physician, VT

For more information visit one of our websites: www.hokiesports.com/trainers/eddieferrell

VCOM http://www.vcom.vt.edu/cme/ Dr. Francine Anderson, P.T., Ph.D. Associate Dean for Post-Baccalaureate Pre-Med Program, VCOM

➤ Contact, Mailing and Lodging information on other side ➤

Place of Employment: ___________________________________________

For Saturday’s Alumni event info please contact Katie Baer at KatieATC@vt.edu

• New Concepts in Ankle Injuries

❑ No

• Cadaver Lab for Ankle

Are you a Virginia Tech Sports Medicine Alumni-❑ Yes

Occupation:__________________________________________________

Director of Athletic Training and Rehab for Virginia Tech

E-mail: _____________________________________________________________________________________________________________________

Mike Goforth, M.S., A.T.C.

(home): __________________________________________________

• New Concepts in Shoulder Rehabilitation

Telephone Number (office):_ _________________________________________

• New Concepts in Shoulder Surgery

City: __________________________________________________________________________ State: ____________ Zip:______________________

• Cadaver Lab for Shoulder

Mailing Address: _____________________________________________________________________________________________________________

➤ Please fill out one form for each person registering. ➤ Those bringing groups of 8 or more may have free registration for one participant.

Morning topics will include:

Saturday, April 30th

Name: _________________________________________________________________________________ Credentials: __________________________

We encourage you to take advantage of this great opportunity to share information with fellow colleagues!

• Sponsored Social

include: Baseline testing, BESS testing, Impact testing, SCAT2 exam, force plate testing, Post-concussion symptoms, Return to play decisions, and much more.

Afternoon topics will include:

Clinic Information

The program schedule is subject to change. A complete agenda and materials will be provided to attendees upon arrival at the clinic.

Course Learning Objectives

• “The Latest in the Concussion Debate” – Topics will

Check one:

✃

Sponsored by the Virginia Tech Sports Medicine Association and the Edward Via College of Osteopathic Medicine (VCOM).

James M. Farmer, M.D.

• Cadaver Lab for skull

Cadaver Course & Clinical Symposium:

health professionals.

Please print or type. Complete one registration form for each registrant. Photocopies are acceptable. Include a check made payable to: VTSPSMA

and any other interested allied

Evening topics will include:

April 29-30, 2011 • VCOM, Blacksburg, VA

therapist assistants, physicians

Friday, April 29th

8th Annual Eddie Ferrell Sports Medicine Clinic

physical therapists, physical

Times to be announced - see the website below for updates.

FORM

A clinic for athletic trainers,

Michael J. Sampson, D.O., FAOASM

Agenda

R E G I S T R AT I O N

2011 Eddie Ferrell Memorial Sports Medicine Clinic

Tentative Speakers

Please cut and return

Please Join Us for the

Eddie Ferrell Memorial Clinic Attn: Katie Baer

Phone: (540) 231-2711 160 Jamerson Athletic Center (0502) Blacksburg, VA 24061 Email: KatieATC@vt.edu — OR —

Fax Completed Registration Form Attn: Katie Baer (540) 231-7335

With fee payment at registration on the day of the event.

CME Credits – M.D.’s:

Evaluation data will be compiled and provided to the VCOM Director of Alumni Relations and Continuing Medical Education. Comments

Blacksburg, VA 24061

Mail Completed Registration Form and Fee:

160 Jamerson Athletic Center (0502)

CME Credits – D.O.’s

Eddie Ferrell Memorial Sports Medicine Clinic

2011 Eddie Ferrell Memorial Sports Medicine Clinic

8TH ANNUAL

Eddie Ferrell Memorial Sports Medicine Clinic

Disclosure Statement

It is the policy of the VCOM Medical Education Department to ensure balance, independence, objectivity, and scientific rigor in all its educational programs.

Friday and Saturday, April 29 & 30, 2011 Edward Via College of Osteopathic Medicine (VCOM) 2265 Kraft Drive Blacksburg, VA 24060

Continuing Education :

NATA: 9.0 CEUs

Sponsored by: The Virginia Tech Sports Medicine Association and the Edward Via College of Osteopathic Medicine (VCOM)

Eddie Ferrell Memorial Clinic Attn: Katie Baer

Phone: (540) 231-2711 160 Jamerson Athletic Center (0502) Blacksburg, VA 24061 Email: KatieATC@vt.edu — OR —

Fax Completed Registration Form Attn: Katie Baer (540) 231-7335

With fee payment at registration on the day of the event.

CME Credits – M.D.’s:

Evaluation data will be compiled and provided to the VCOM Director of Alumni Relations and Continuing Medical Education. Comments

Blacksburg, VA 24061

Mail Completed Registration Form and Fee:

160 Jamerson Athletic Center (0502)

CME Credits – D.O.’s

Eddie Ferrell Memorial Sports Medicine Clinic

2011 Eddie Ferrell Memorial Sports Medicine Clinic

8TH ANNUAL

Eddie Ferrell Memorial Sports Medicine Clinic

Disclosure Statement

It is the policy of the VCOM Medical Education Department to ensure balance, independence, objectivity, and scientific rigor in all its educational programs.

Friday and Saturday, April 29 & 30, 2011 Edward Via College of Osteopathic Medicine (VCOM) 2265 Kraft Drive Blacksburg, VA 24060

Continuing Education :

NATA: 9.0 CEUs

Sponsored by: The Virginia Tech Sports Medicine Association and the Edward Via College of Osteopathic Medicine (VCOM)

Eddie Ferrell Memorial Clinic Attn: Katie Baer

Phone: (540) 231-2711 160 Jamerson Athletic Center (0502) Blacksburg, VA 24061 Email: KatieATC@vt.edu — OR —

Fax Completed Registration Form Attn: Katie Baer (540) 231-7335

With fee payment at registration on the day of the event.

CME Credits – M.D.’s:

Evaluation data will be compiled and provided to the VCOM Director of Alumni Relations and Continuing Medical Education. Comments

Blacksburg, VA 24061

Mail Completed Registration Form and Fee:

160 Jamerson Athletic Center (0502)

CME Credits – D.O.’s

Eddie Ferrell Memorial Sports Medicine Clinic

2011 Eddie Ferrell Memorial Sports Medicine Clinic

8TH ANNUAL

Eddie Ferrell Memorial Sports Medicine Clinic

Disclosure Statement

It is the policy of the VCOM Medical Education Department to ensure balance, independence, objectivity, and scientific rigor in all its educational programs.

Friday and Saturday, April 29 & 30, 2011 Edward Via College of Osteopathic Medicine (VCOM) 2265 Kraft Drive Blacksburg, VA 24060

Continuing Education :

NATA: 9.0 CEUs

Sponsored by: The Virginia Tech Sports Medicine Association and the Edward Via College of Osteopathic Medicine (VCOM)