COG RT_Dallas flyer_regform 29may15

To get to the right treatment…

UP TO

40O

$

HUR RY!

BEST R ATES EN D SOON

CO G N

TI V E COG N I TIO N I L I TA R E H A B UA L MAN

IT I V E REHAB I L ITAT

D C E- B A SE E V ID EN T IC E AT IN G O PR AC T IN S T R A N SL IO N M EN DAT R EC O M D

A N UA ION M L

Primar y

Edmund

Author

Hook Re

C. Ha sk

habilitatio

ins, Ph

n Cente

r, Indian

apolis, Ind

You need to know ALL of the strategies

iana

FACR M Jersey PP-Cn, on, New PhD, AB erone, itute, Edis Keith Cic Rehabilitation Inst n k JFK Johnso r, PhD New Yor -O’Conno ne, New York, ms Da Kristen i School of Medici Sina LP unt Mo C-S , MA , CC iana rle Ind Ebe on, omingt Rebecca iver sity, Blo York M k, New Indiana Un D, FACR New Yor bahn, Ph Medicine, Langen abilitation Donna itute of Reh , PhD Rusk Inst k osenbaum hing, New Yor o-R pir Amy Sha Care Center, Flus race iana Park Ter polis, Ind PhD , Indiana Trexler, al of Indiana Lance E. on Hospit Editor Rehabilitati Managing

thors ting Au Contribu and Editors AC RM

pproach.”

| Am eric an Con gre ss

sed t ormat tha o atients wh

of Reh abil itation Me

tion

Spe cial

Inte res t

ISIG Gro up (BI-

BR AIN

INJ URY

scip – Inte rdi

cia l lina ry Spe

Inte res t

-ISI G) Gro up (BI

Me

for

nts

$

AC

RM

15 0

Cognitive Rehabilitation Training

cou

FIRST Edi

shing

Dis

FI

RS TE

mb

ers

di t

io n

dici ne

nd all-n ingle or sm cenly eviden the clinical

plin ary

SAVE

11/16/12

1:10 PM

)

Printed Manual included

150 Value

$

26 – 27 OCTOBER 2015 at HILTON ANATOLE

DALL AS, TX, USA

TELL YOUR COLLEAGUES

based on the Cognitive Rehabilitation Manual T W O DAY S L I V E I N S T R U C T I O N with Authors of the Manual Make sure you and your team have ALL of the up-to-date cognitive rehabilitation strategies. The ACRM Manual and the LIVE training encompass ALL of the evidence-based cognitive rehabilitation interventions. Worksheets included.

S PAC E I S LI M I T E D

M O R E : W W W. AC R M .O R G /C O G

SI

W W W.ACRM.ORG

PHONE: +1.703.435.5335

N C E 19 2 3

COGNITIVE REHABILITATION TRAINING T W O DAY S L I V E I N S T R U C T I O N 26 – 27 O C TO B E R 2 015 // DA L L A S , T X

CONTACT INFORMATION

DR.

MR.

MRS.

MS.

MISS

> FIRST NAME

LAST NAME

CREDENTIALS

> SPECIALIZATIONS

FACILIT Y / ORGANIZATION

TITLE / WORK FUNCTION

MAILING ADDRESS LINE 1

MAILING ADDRESS LINE 2

> > > > > > >

CIT Y

STATE / PROVINCE

EMAIL ADDRESS

COUNTRY

MOBILE PHONE

SPECIAL NEEDS

WORK PHONE

ADA / Accessibility Needs: Dietary Needs:

EMERGENCY CONTACT

BILLING ADDRESS

EMERGENCY PHONE

PAYMENT

ZIP / POSTAL CODE

$___________TOTAL AMOUNT in USD

Address 1

Check/Money Order (US Funds Only) Check #__________ payable to: ACRM

Address 2

Credit Card (fill out information below)

City

¨ MasterCard ¨ Visa ¨ American Express ¨ Discover Credit Card #:__________________________________________________ Expiration Date:__________________

Must match credit card address. ¨ Check if same as mailing address above.

Security Code:_______________

Zip / Postal Code “The Cognitive Rehabilitation Manual is a landmark volume into clearly described procedures translating decades of research indispensable for working invaluable guide to the evidence-based clinicians. This manual is an practice of cognitive rehabilitation or without strong research for clinicians with backgrounds.”

Country

James F. malec, PhD, aBPP-cn, RP, FacRm RehaBilitation hosPital oF inDiana, inDianaPolis, in

“This manual has moved the post-acute brain injury industry providing clear guidelines significantly forward by for delivering ‘best practice’ cognitive rehabilitation.” siD Dickson, PhD, aBPP Pate RehaBilitation,

“Useful for both experienced

professionals in cognitive rehabilitation

based training; one printed copy of the ACRM Cognitive Rehabilitation Manual ($150 value); CME/CEU credits; and six months of online access to a previously recorded Cognitive Rehabilitation Training.

STUDENT / RESIDENT / FELLOW & EARLY CAREER

To receive the Member Rate, one must be an active ACRM Member (not a Special Interest or Networking Group member only) at time of registration. If a credit card is declined, you will be notified and asked for an alternative payment method.

QUESTIONS about REGISTRATION STATUS? Contact: MemberServices@ACRM.org or call +1.703.574.5845

EVERYONE ELSE

Produced by ACRM Publishing US $150 —FIRST EDITION

BR AIN INJURY – Interdisciplinary Special Interest Group (BI-ISIG)

COG_CG_cover_FirstEDFULL_

15Nov_vF.indd 1-3

Edmund C. Haskins, PhD

Managing Editor

Indianapolis, Indiana

Keith Cicerone, PhD, ABPP-Cn, FACRM JFK Johnson Rehabilitation Institute, Edison, New Jersey Kristen Dams-O’Connor, PhD Mount Sinai School of Medicine, New York, New York Rebecca Eberle, MA, CCC-SLP Indiana University, Bloomington, Indiana Donna Langenbahn, PhD, FACRM Rusk Institute of Rehabilitation Medicine, New York, New York Amy Shapiro-Rosenbau m, PhD Park Terrace Care Center, Flushing, New York Lance E. Trexler, PhD Rehabilitation Hospital of Indiana, Indianapolis, Indiana

FIRST Edition

INCLUDES: Two days of evidence-

American Congress of Rehabilitation Medicine

DR BRian WalDRon acqUiReD BRain inJURy, DUBlin, iRelanD

¨ I have read the Cancellation Policy

PLEASE NOTE

nh (Usa)

“The manual is well aimed at ACBIS qualified staff and Clinical Occupational Therapists. It covers many of the well-researched Psychologists and case studies and the larger and presented single or small-n group based in my view and it succeeds outcome studies up to the present. It is certainly evidencein translating the disparate literature to workable recommendations evidence base in the clinical for staff on the ground.”

Contributing Authors and Editors

|

PLEASE CHECK

Received at the event DaviD J. haJJaR, ms, ccc-slP cRotcheD moUntain FoUnDation, GReenFielD,

TR ANSLATI NG EVIDENC E-BASED RECOMM ENDATIO NS INTO PR ACTICE Hook Rehabilitation Center,

and for a first approach.”

“The Cognitive Rehabilitation Manual is a comprehensive research practices organized collection in a clear manner. The information of evidence-based will benefit both seasoned is presented in a format professionals and entry level clinicians working with patients that present with cognitive/communic who ation deficits.”

COG NITI VE REH ABIL ITAT ION MAN UAL Primary Author

Dallas, tX (Usa)

ACRM

COST includes a printed copy of the Manual ($150 VALUE!).

>> For substitutions, the individual attending will be charged $170 USD.

M A N UA L

DiRectoR oF BRain inJURy ReseaRch shePheRD centeR, atlanta, Ga (Usa)

Paolo BolDRini, mD, osPeDale ca’ Foncello, Piazzale osPeDale tReviso, italy

>> Registration cancellation and/or changes must be submitted to sbarrah@ACRM.org by 31 August 2015. >> No cancellations will be accepted by phone. >> Substitutions must be received and approved by 31 Aug 2015. >> All cancellations and substitutions will be charged a fee of $170 USD or 50 percent of registration paid, whichever is greater.

(Usa)

“Thoughtfully organized, practical, techniques for delivering cognitive and invaluable — this manual provides step-by-step delivery of cognitive rehabilitation therapies. This promises to be an essential guide to the services for persons with brain RonalD t. seel, PhD injury.”

Cardholder’s Signature: ___________________________________________

CANCELLATION POLICY

CO G N IT I V E R E H A B I L ITAT I O N

Print name as it appears on card:_____________________________________

State / Province

BR AIN INJURY – Interdisciplinary Special Interest Group (BI-ISIG)

FIR

ST

it Ed

$ Dis

ADVANCE RATE

BEFORE 30 JUNE

EARLY BIRD

n io

0 15

cou

nts

for

AC

RM

Me

mb

ers

11/16/12 1:10 PM

REGULAR

ON-SITE

1 JULY – 31 JULY 1 AUG – 24 OCT

25 – 30 OCT

MEMBER

295

395

495

695

NON-MEMBER

395

495

595

795

MEMBER

395

495

595

795

NON-MEMBER

495

595

695

895

STUDENT / RESIDENT / FELLOW: Enrolled in an accredited school of medicine, an approved graduate or undergraduate program, or fellowship in a medical rehabilitation discipline are eligible for this discounted rate. Current ID required at registration check-in.

EARLY CAREER: Professionals during first five years after completion of post-graduate studies.

NON-MEMBER: Includes a bonus 6-month introductory ACRM membership with access to all interdisciplinary special interest groups and networking groups, and discounted member rates on ACRM products and events.

SUBMIT OPTIONS: FAX this form and payment to: +1.866.692.1619 or MAIL to: ACRM PO Box 759272, Baltimore, MD 21275-9272 29 0 515

ACRM | AMERICAN CONGRESS OF REHABILITATION MEDICINE ACRM DUNS # 010280 014 / ACRM FEDER AL ID # 36 -217078 4

TEL: +1.703.435.5335

www.ACRM.org/COG