Greensboro AHEC Fall 2012 Continuing Education Catalog by Greensboro AHEC

Fall 2012 Catalog uc a t ion for O c tob er t hrough Ja nua r y d E g n i u n i t G r e e n s b o r o A H EC C o n

AHEC Greensboro

Area Health Education Center Connecting People, Education, and Health

Introducing our Fall 2012 Catalog that includes up-todate information on the Continuing Education courses you need. For detailed course information and online registration, visit www.gahec.org.

Serving healthcare professionals acrosss NC since 1972.

Multi-Disciplines Greensboro AHEC is accredited by the North Carolina Medical Society to provide continuing medical education for physicians. Greensboro AHEC adheres to ACCME, ACPE, and ANCC Standards regarding industry support of continuing education.

Welcome

Jane Nester, Dr.P.H.

Oct 5 4th Annual A Day of Critical Care Symposium

Event # 37977 • 8:30 a.m. – 3:45 p.m. (Check-in 8 a.m.) Proximity Hotel, 704 Green Valley Road, Greensboro, NC Fee: $125 (early bird), $145 (after 9/3/12) (Lunch included) Credits: 6 AMA PRA Category 1 CreditTM; 0.6 CEU; 6 Contact Hours; 6 ACPE (0046-9999-12-168-L01-P)

It is our pleasure to welcome Jane Nester, Dr.P.H., as Executive Director of Greensboro AHEC and Medical Education with Cone Health. Dr. Nester joins us from Memorial University Medical Center in Savannah, Georgia. She has served as Director for Medical Education Administration for the past six years. Dr. Nester brings more than 25 years of progressive healthcare leadership experience in education, management and research. Most importantly, she brings a passion for primary care. Her past achievements include award winning, collaborative initiatives in quality and performance improvement. We are honored to have Dr. Nester provide leadership in fulfilling the Greensboro AHEC mission, of enhancing quality educational service for healthcare professionals in our region.

Oct 15-16 Journey of Growth: Enneagram Levels

of Development

Event # 37601 • 9 a.m. – 4:30 p.m. (Check-in 8:30 a.m.) Deep River Event Center, 606 Millwood School Road Greensboro, NC 27409 Fee: $230 (early bird); $245 (after 9/30/12) (Lunch included) Credits: 1.2 CEU; 12 Contact Hours; 12 Contact Hours (Category A) CE for NC Psychologists; 12 NBCC; 12 NCSAPPB SS

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Multi-Disciplines Nov 2

Nov 2

Nov 30

The 2012 Diabetes Summit

Improving Performance in Practice Series Fee: Free • A. Change Package Overview Credits: 0.2 CEU • B. Measures and Statistics Credits: 0.1 CEU; 1 Contact Hour

Event # 37569 • 8 a.m. – 4:30 p.m. (Check-in 7:30 a.m.) Moses Cone Hospital, Room 0030 Fee: $115 (Lunch included) Credits: 7 AMA PRA Category 1 Credit; 0.7 CEU; 7 CNE Contact Hours (AP004-1260); 7 Contact Hours; 7 CPEUs; 7 ACPE (0046-9999-12-167-L01-P)

It is the NC Law… Infection Control Workshop for Home Care and Hospice

What Do I Say? A Course in Talking About Death and Dying

Fee: $159 • Credits: 0.8 CEU; 8.0 Contact Hours

Medical Home and Quality Training

Event # 37332 • 8:30 a.m. – 4:30 p.m. (Check-in 8 a.m.) Wesley Long Community Hospital, Auditorium Fee: $125; $55 for Greensboro Hospice & Palliative Care Staff (Lunch included) Credits: 0.7 CEU; 7 Contact Hours; 7 Contact Hours (Category A) CE for NC Psychologists; 7 NBCC (Provider #5470); 6.75 NHA Hours (pending); 6.0 NCBPTE

Fee: Free • Credits: 0.1 CEU; 1 Contact Hour

Pandemic Influenza

Fee: $5 • Credits: 0.2 CEU; 2 Contact Hours

Performance Coaching for Healthcare Professionals Fee: Free • Credits: 0.2 CEU; 2 Contact Hours

Pesticide Related Illness and Health Issues

Health Law and Ethics Update 2012: Year in Review

Fee: Free • Credits: 3.2 CNE Contact Hours; 0.32 CEU

Treating the Invisible Wounds of War Series (TTIWW) Fee: Free • Treating the Invisible Wounds of War Credits: 4.0 NBCC Hours (Provider #5470); 4.0 CNE Contact Hours (AP004-1211); 4.0 DC Contact Hours; Contact Hours; 0.4 CEU; 4 Contact Hours (Category B) CE for NC Psychologists • Treating the Invisible Wounds of War (Spanish Language Edition) Credits: 4.0 NBCC Hours (Provider #5470); 4.0 CNE Contact Hours (AP004-1211); 4.0 DC Contact Hours; Contact Hours; 0.4 CEU; 4 Contact Hours (Category B) CE for NC Psychologists • Issues of Women Returning from Combat Credits: 3.0 Contact Hours NBCC (Provider #5470); 3.0 CNE Contact Hours (AP004-1212); 3.0 Contact Hours; 0.3 CEU; 3.0 DC Contact Hours; 3 Contact Hours (Category B) CE for NC Psychologists • A Primary Care Approach Credit: 1.0 AMA PRA Category 1 Credit, 1.0 AAFP Prescribed • Recognizing the Signs of Mild Traumatic Brain Injury during Routine Eye Examinations 2.0 COPE Hours (Course ID: 32660-NO); 0.2 CEU • Understanding Military Family Issues 3.0 Contact Hours; 0.3 CEU; 3 NBCC Contact Hours (Provider #5470)

Event # 37401 • 9 a.m. – 4:30 p.m. (Check-in 8:30 a.m.) Moses H. Cone Memorial Hospital, Room 0030 Fee: $115 (Lunch included) Credits: 0.6 CEU; 6 Contact Hours; 6 Contact Hours (Category A) CE for NC Psychologists; 6 NBCC (Provider #5470); 6 NCSAPPB SS; 6.0 NCBPTE

Online Courses (Fees subject to change) Register online @ www.aheconnect.com

An Overview of Meaningful Use

Fee: Free • Credits: 0.1 CEU; 1 Contact Hour

Chronic Disease Prevention Program A: Myocardial Infarction Fee: $5 • Credits: 0.1 CEU; 1 Contact Hour

Dysphagia Assessment: A Screening Protocol for Stroke Patients

Sensory Changes in the Adult Patient Population

Fee: $5 • Credits: 0.5 CNE Contact Hour; 0.05 CEU

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PDF

Fee: $20 • Credits: 1.5 ACH/DOM Hours; 0.15 CEU; 1.5 Contact Hours

Program handouts will be available online only, one week prior to programs for registered participants. Go to www.gahec.org

Working with Interpreters in Healthcare Fee: Free • Credits: 0.1 CEU; 1 Contact Hour

7th Annu al N orth Carolin a W omen’s Health S ymposium

SAVE-THE-DATE

6th Annual Cone Health Heart and Vascular Symposium Friday, February 22, 2013

Friday, March 15, 2013 Embassy Suites, 204 Centreport Drive Greensboro, NC

Moses Cone Hospital, AHEC Classroom 0030

An interdisciplinary and comprehensive update on the most recent advances in cardiovascular care.

Detailed course information & online registration @ www.gahec.org

Easy online registration @

Mental Health

Allied Health

Oct 11

Check in the Nursing & Multi Disciplines sections for other programs of interest to Allied Health professionals.

Online Courses

Clinical Management of PTSD

Event # 37442 • 9 a.m. – 4:30 p.m. (Check-in 8:30 a.m.) Moses H. Cone Memorial Hospital, Room 0030 Fee: $115 (Lunch included) Credits: 0.6 CEU; 6 Contact Hours; 6 Contact Hours (Category A) CE for NC Psychologists; 6 NBCC; 6 NCSAPPB GSB

Oct 15-16 Journey of Growth: Enneagram Levels

Conscious Sedation and Respiratory Care

Fee: $15 Credits: 1.5 CNE (AP004-1177), 1.5 NCRCB CE Hours (Approval # 122133), 0.15 CEU, 1.5 Contact Hours

ICD-9 Coding 1: Introduction

Fee: $119.00 • Credits: 0.2 CEU; 2.0 Contact Hours

ICD-9 Coding 2: Principles

Fee: $119.00 • Credits: 0.2 CEU; 2.0 Contact Hours

Home Care Chronic Disease Prevention Training: A Train-the-Trainer Course

Oct 22

Fee: $10 • Credits: 0.1 CEU; 1.0 Contact Hour

Stroke Rapid Response (National Stroke Association) Fee: $20 • Credits: 0.2 CEU; 2.0 Contact Hours

Dentistry Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by state or provincial board of dentistry or AGD endorsement – 10/1/2012 to 9/30/2016 Provider ID# 217248

Event # 37274 • 9 a.m. – 1:15 p.m. (Check-in 8:30 a.m.) Moses Cone Hospital, Room 0030 Fee: $125 Credits: 4 AGD; 0.4 CEU; 4 Contact Hours; 4 Continuing Education for Dental Hygienists

Fee: Part A: $240; Part B: $320 Credits: After completing both Part A and B of the Intraoral Radiography program, you will receive a Certificate in Intraoral Radiography awarded by the UNC School of Dentistry.

Event # 37455 • 9 a.m. – 4:30 p.m. (Check-in 8:30 a.m.) Moses H. Cone Memorial Hospital, Room 0030 Fee: $115 (Lunch included) Credits: 0.6 CEU; 6 Contact Hours; 6 Contact Hours (Category A) CE for NC Psychologists; 6 NBCC; 6 NCSAPPB SS

Time-Limited Dynamic Psychotherapy: An Inclusive Relational Model

Dec 5-7

Child Forensic Interviewing: Using the RADAR Protocol

Online Course

Cognitive-Behavioral Therapy (CBT): Evidenced-Based Treatment of Mood and Anxiety Disorders

Nov 5

Oct 12 Dental OSHA Update 2012

of Development

Event # 37828 • 9 a.m. – 4:30 p.m. (Check-in 8:30 a.m.) Moses H. Cone Memorial Hospital, Room 0030 Fee: $115 (Lunch included) Credits: 0.6 CEU; 6 Contact Hours; 6 Contact Hours (Category A) CE for NC Psychologists; 6 NBCC

Event # 37699 • 9 a.m. – 4:30 p.m. (Check-in 8:30 a.m.) Moses H. Cone Memorial Hospital, Room 0030 Fee: $275 (Lunch included) Limited to 16 registrations Credits: 1.8 CEU; 18 Contact Hours; 18 Contact Hours (Category A) CE for NC Psychologists; 18 NBCC (Provider #5470)

Online Courses

SAVE-THE-DATE

Fee: $35 • Credits: 3.0 NBCC, 0.3 CEU, 3.0 Contact Hours

Guilford County Dental Society – Golden Triad

From Theory to Practice: Case Studies in Ethical Decision-Making

(A supplemental course to Perspectives in Ethical Decision-Making) Fee: $10 • Credits: 1.0 NBCC; 0.1 CEU; 1.0 Contact Hour

Friday, February 8, 2013

Getting to Yes! A Dental Team’s Guide to 100% Case Acceptance Gary M. DeWood, DDS, MS

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Program handouts will be available online only, one week prior to programs for registered participants. Go to www.gahec.org

Mental Health

Nursing Other Nursing programs are listed in the Multi Disciplines and Mental Health sections.

Children and Domestic Violence Series

Fee: $5 • Credits: 1.0 NBCC; 0.1 CEU; 1.0 Contact Hour • Trauma and Children • Assessment • Behavior Management • Impact of Maternal Mental Health on Children Exposed to Domestic Violence • Legal Issues

“Greensboro AHEC is an approved provider of continuing nursing education by the North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.”

Oct 24

Duke Mental Health Webinars

Fee: Free • Credits: 0.1 CEU 21: The Treatment of Insomnia 22: Sexual Side Effects of Psychotropics in Males and Females 23: Treatment of Resistant Depression 24: Management of Comorbid Insomnia and Depression 25: Depression in Late Life: An Update 26: Intensive Outpatient Treatment of Substance Abuse 27: New & Promising Treatments for ADHD in Children 28: Borderline Personality and Emotion: Using Research to Improve Clinical Practice 29: Obsessive Compulsive Disorder (OCD) in Children and Adolescents 30: Mindfulness Practice as a Clinical Intervention 31: Treatment of Agitation in Dementia 32: The Use of Generic & Brand Medications in Psychiatry 33: School Refusal Behavior in Children and Adolescents 34: Boundary Violations in Clinical Practice 35: A National Epidemic of Unintentional Prescription Opioid Overdose Deaths: How Physicians Can Help Control It 36: Making Shift Happen: A Motivational Interviewing Primer for Mental Health Professionals 37: An Update on Starting & Managing Patients on Clozapine 38: The Anxiety and Somatoform Disorders 39: Cognitive Behavioral Therapy for Children and Adolescents with Anxiety Disorders 40: Pharmacologic Management of Behavioral & Psychological Symptoms of Dementia 41: Overview of the Dialectical Behavioral Therapy (DBT) for Physicians, NEW Nurses & Others not Providing Psychotherapy 42: ADHD: Impact and Cost Effective Treatment NEW 43: Needs, Access and Treatment Issues in Addressing PTSD in Military Populations NEW 44: Perinatal Psychiatry: Preconception, Pregnancy, Postpartum NEW

Oct 26

Event # 37313 • 8:30 a.m. – 3:45 p.m. (Check-in 8 a.m.) Randolph Hospital Health Education Center 200-A Foust St, Asheboro Fee: $115; $75 for Randolph Hospital Employees (Lunch included) Credits: 0.6 CEU; 6 CNE Contact Hours (AP004-1252); 6 Contact Hours

Why Can't We Be Friends? Workplace Issues that Divide Teams and Undermine Patient Safety

Event # 37480 • 8:30 a.m. – 3:30 p.m. (Check-in 8 a.m.) Moses Cone Hospital, Room 0030 Featuring Barbara E. McNeill, MSN, RN-BC Fee: $115 (Lunch included) Credits: 5.5 Contact Hours; 0.55 CEU; 5.5 CNE Contact Hours (AP004-1259)

Online Courses

Fee: Free • Credits: 0.1 CEU, 1 Contact Hour; 1.0 CNE Contact Hour (AP004-1187)

National Stroke Association

Fee for each course: $20 Credits for each course: 0.15 CEU; 1.5 Contact Hours unless otherwise noted • Interpreting Stroke Imaging and Other Diagnostics • Limiting Complications of Stroke • Neurological Assessments • Patient & Care Partner Education • Preventative Nursing Care for Neurological Deficits • Stroke 101: Anatomy and Physiology • Therapies & Nursing Care • Stroke on the Critical Care Unit - 2.0 Contact Hours • Rehabilitation Nursing for Stroke - 2.0 Contact Hours

El Futuro Latino Mental Health Series

Fee: $5 unless otherwise noted • Credits: 1.0 NBCC Hours; 0.10 CEU; 1.0 Contact Hours unless otherwise noted. • An Overview of Mental Health Issues in the North Carolina Latino Community • Culture Bound Syndromes • He Treated Me Like An Animal - The Impact of Discrimination on Latino Mental Health • A Culturally-Sensitive Approach to Domestic Violence Treatment with Latinos • Si Dios Lo Permite: The Role of Spirituality in Working with Latinos • Hablando Claro: Talking with Latino Patients about Psychiatric Illness

School Mental Health Project

Nurse Refresher Program

Fee: $25 per course • Credits: 0.2 CEU; 2.0 CNE Hours; 2 Contact Hours Public School Personnel Renewal Credit; 2 NCSAPPB-GSB Hours; 2 NBCC Hours See course listings on www.aheconnect.com/behavioralhealth

If you are a registered nurse interested in re-entering nursing practice, call Ann North at 336-832-8210 for more information.

AHEC Digital Library http://library.ncahec.net Detailed course information & online registration @ www.gahec.org

Dealing with Neurological Dysfunctions: The Nurse's Role

Nursing Nursing Management Institute Series (NMI)

UNCG Geriatric Training Series

Fee for each course: $25 • Credits for each course: 2.0 CNE Contact Hours (AP006-NMI003); 0.2 CEU • Applying Regulations to Practice • Becoming a Systems Thinker • Communicating Effectively • Improving Outcomes through Quality Management • Integrating Financial Data • Managing for Retention • Maximizing Group Potential • Sharing Decision Making • Transitioning from Staff Nurse to Manager • Mentoring and Being Mentored • Using Data for Staffing

Fee for each course: $10 Credits: 0.5 CNE Contact Hours; 0.05 CEU; 0.5 Contact Hours (unless otherwise noted) • About Aging • Cultural Perspectives of Aging • Depression, Delirium and Dementia Credit: 0.75 CNE Contact Hours; 0.05 CEU; 0.75 Contact Hours • Economic and Environmental Issues of Aging • Elder Mistreatment • End of Life Care for Older Adults 1.25 CNE Contact Hours; 0.1 CEU; 1.25 Contact Hours • Ethical Issues in Aging Credit: 0.75 CNE Contact Hours; 0.05 CEU; 0.75 Contact Hours • Falls in Older Adults • Gerontological Assessment • Integument and Aging • Interdisciplinary Collaboration for Elder Care • Medication Use Credit: 0.75 CNE Contact Hours; 0.05 CEU; 0.75 Contact Hours • Nutrition and Aging Credit: 0.75 CNE Contact Hours; 0.05 CEU; 0.75 Contact Hours • Pain and Aging Credit: 0.75 CNE Contact Hours; 0.05 CEU; 0.75 Contact Hours • Physical Restraint Reduction • Sensory Changes and Communication Credit: 1.0 CNE Contact Hour; 0.1 CEU; 1.0 contact hour • Sleep/Rest • Teaching Older Adults • Urinary Incontinence Credit: 0.75 CNE Contact Hours; 0.05 CEU; 0.75 Contact Hours

Sexual Assault Nurse Examiner Training Series

Fee for each course: $25 • SANE Series: A. Introduction To Forensic Nursing Credits: 1.5 CNE, 0.15 CEU (1.5 Contact Hours) • SANE Series: B. Introduction To Sexual Assault Credits: 1.5 CNE, 0.15 CEU (1.5 Contact Hours) • SANE Series: C. The Rapist and Criminal Sexuality Credits: 1.5 CNE, 0.15 CEU (1.5 Contact Hours) • SANE Series: D. Anatomy and Physiology for the Sexual Assault Examination Credits: 1.5 CNE, 0.15 CEU (1.5 Contact Hours) • SANE Series: E. Interviewing the Sexual Assault Patient Credits: 1.5 CNE, 0.15 CEU (1.5 Contact Hours) • SANE Series: F. The Sexual Assault Exam Credits: 3.75 CNE, 0.35 CEU (3.5 contact hours) • SANE Series: G. Introduction to Pediatric Sexual Abuse Credits: 2.0 CNE, 0.20 CEU (2.0 contact hours) • SANE Series: H. Infections and Prophylaxis for the Sexual Assault Patient Credits: 2.0 CNE, 0.20 CEU (2.0 contact hours) • SANE Series: I. Forensic Injury Identification and Documentation Credits: 1.75 CNE, 0.175 CEU (1.75 contact hours) • SANE Series: J. Principles of Physical Evidence Collection in Sexual Assault Credits: 1.5 CNE, 0.15 CEU (1.5 Contact Hours) • SANE Series: K. The Sexual Assault Evidence Collection Kit Credits: 1.5 CNE, 0.15 CEU (1.5 Contact Hours) • SANE Series: L. DNA & Forensic Analysis Credits: 1.5 CNE, 0.15 CEU (1.5 Contact Hours) • SANE Series: M. Principles of Forensic Photography Credits: 2.0 CNE, 0.20 CEU (2.0 contact hours) • SANE Series: N. Sexual Assault and the Criminal Justice System Credits: 2.0 CNE, 0.20 CEU (2.0 contact hours)

your Schedule cours es tod ay! Visit gahec .org

What you do could change the rest of her life.

Become a Sexual Assault Nurse Examiner.

Easy online registration, handouts, and certificates.

Sexual Assault Nurse Examiner (SANE) Training

Go to www.gahec.org.

Blended Learning with online and classroom components

Earn a Nursing Management Certificate Online

Online: $25 per course

Sexual Assault Nurse Examiner Training

Visit the website for more information

aheconnect.com/nmi

For more information, visit www.aheconnect.com/SANE 5

Detailed course information & online registration @ www.gahec.org

Pharmacy

Spanish

Other Pharmacy programs are listed in the Multi Disciplines sections. For more information on Certificate Programs,

Online Courses

contact Dawn Pettus at dawn.pettus@conehealth.com

El Futuro Latino Mental Health Series

The University of North Carolina Eshelman School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Fee: $5 unless otherwise noted Credits: 1.0 NBCC Hours; 0.10 CEU; 1.0 Contact Hours unless otherwise noted. See course listings under “Mental Health”.

Introductory Spanish for Healthcare Providers Fee: $15 • Credits: 0.1 CEU, 1.0 Contact Hour

Treating the Invisible Wounds of War (Spanish Language Edition)

New Reporting of ACPE Attendance

ACPE and NABP are moving to electronic reporting of pharmacy CE attendance. Program attendees will need to submit their personal NABP e-profile ID to ACPE as attendance verification. Please to go to: www.MyCPEmonitor.net to get your NABP e-profile ID. The NC Board of Pharmacy will still require self reporting of CE attendance by pharmacists and pharmacy technicians and only use the CPE monitor as a verification step initially.

Fee: Free • Credits: 4.0 NBCC Hours (Provider #5470); 4.0 CNE Contact Hours (AP004-1211); 4.0 DC Contact Hours; Contact Hours; 0.4 CEU; 4 Contact Hours (Category B) CE for NC Psychologists

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Online Courses

Important Information

Fee: Free

Lunch is included with most programs. Please call 336-832-8025 for special dietary needs. Online Certificates Program evaluations and certificates can be accessed from the “My CE Area” on www.gahec.org. Program Handouts Online Program handouts will be available in PDF format online only, one week prior to programs for registered participants. Go to www.gahec.org and click My CE Area.

Treating the Invisible Wounds of War (TTIWW) Series:

Substitutions Welcome Just call 336-832-8025 to let us know information about substitutions.

Understanding Military Family Issues Sheds light on issues throughout the deployment cycle and provides resources for helping your patient

Vouchers Available Notify us two days prior to program if you cannot attend in order to receive a voucher for the amount paid. If a refund is preferred, it must be requested at least two business days in advance. A 30% administration fee will be deducted.

ADA Services Provided If you need services or auxiliary aids covered by ADA call us in advance at 336-832-8025.

Subscribe to our CE RSS Feed

Directions and Parking Directions are provided to our programs on the Greensboro AHEC website at www.gahec.org. Please use these directions and not MapQuest. Parking at Moses Cone Hospital, The Women’s Hospital of Greensboro, and Wesley Long Community Hospital is free.

Go to www.gahec.org and locate the RSS feed button in the toolbar at the top of your browser window. Click on the drop-down arrow. A list of all available feeds by discipline will appear. Select the feed(s) you want to follow and a new window will pop up. It will display a typical feed page and prompt you at the top to “Subscribe to this feed”. After you subscribe, it will be available for viewing in your feed reader.

Detailed course information & online registration @ www.gahec.org

For Inclement Weather Accommodations Call 336-832-8025 for up-to-date information on cancelled or rescheduled programs. Administrative Offices 200 E. Northwood Street, Northwood Building Greensboro, North Carolina 27401 336-832-8025 © 2012 Greensboro AHEC

Registration

Payment must be received with registration. Please make checks payable to: Greensboro AHEC

If you prefer to register online, go to www.gahec.org and click “Search for a Course.” Next, click on the course you want to attend. Click on the link at the bottom of the page that says “Click Here To Register Online For This Event” where you are taken to a secure Online Registration Area. Type in your last name and last 4 digits of your social security number and follow the remaining steps.

FAX this form to: 336-832-7591 • Or MAIL to: Greensboro AHEC, 1200 N. Elm St., Greensboro, NC 27401-1020

PID #: _____________________________ Last name + last 4 digits of social security #. Your Personal ID (PID) is the ONLY personal data you need to provide if you have received a PID # from previous AHEC programs. If you have changes to your personal information or have never received an AHEC PID, complete the information below.

Name ________________________________________________________________ Last 4 digits of SS# FIRST

LAST

SUFFIX

Phone: ________________________________________________________________ Certification/Degree: _________________________ HOME

OFFICE

Fax ___________________________________________________________________ Employer __________________________________ HOME

OFFICE

Email _________________________________________________________________ Title ______________________________________ HOME

OFFICE

Office Address ________________________________________ City _______________________ State __________ Zip ________ Home Address ________________________________________ City _______________________ State __________ Zip ________ Desired Credit ________________________________________ Discipline: Circle one: Allied Health, Dentistry, Health Careers, Medicine (MDs only), Mental Health, Nursing, Other, Pharmacy, Public Health Specialty __________________________________________ (Ex. Counselor, Dentist, Physical Therapy, Registered Nurse, Social Worker) NEW for ACPE Credit CPE Monitor Information (For Pharmacist and Pharmacy Technicians only) NABP e-Profile ID: ____________________________________________________________ DOB: MM/DD: _____________________ By providing your fax number, email address and telephone number, you have granted permission for us to contact you via the numbers and addresses indicated. Special dietary needs ______________________________________________________________________________________________ How did you find out about this program?  Brochure  Catalog  Email  Flyer  Website  Facebook Payment Options: (Check one)

Payment must be received with registration.

 Check enclosed  MCHS Internal Transfer: 13-digit Cost Center # _

_ - _ _ _ _ _ - _ _ _ _ _ _  Credit Card

Indicate Credit Card Type: (these only)  VISA  MasterCard (NOTE: Your statement will show, “Moses Cone-AHEC”) Card #: ____________________________ Exp. Date: ________

Name ________________________________________________ Cardholder Signature _________________________________________ Course Selections

EVENT TITLE

EVENT #

EVENT DATE

Total Amount enclosed for Event(s)

iCall 336-832-8025 for more information.

FEE

Detailed course information & online registration @ www.gahec.org

Connecting People, Education, and HealthElectronic Service Requested

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Area Health Education Center

Cone Health Greensboro Area Health Education Center 1200 North Elm Street Greensboro, NC 27401-1020 se rec

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Permit No. 195 Greensboro

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AHEC Greensboro

Continuing Education

Fall 2012-13 Catalog OCTOBER – JANUARY

Scan QR code to find detailed course descriptions.

AHEC Greensboro

Area Health Education Center Connecting People, Education, and Health

Recipient of the National AHEC Award for Excellence

Greensboro AHEC accepts award for "Transforming Education Delivery through Online Classes" at the National AHEC Organization Conference in San Antonio, Texas.

Easy Ways to Register for an Event

Serving Alamance, Caswell, Chatham, Guilford, Montgomery, Orange, Randolph, and Rockingham Counties

1. Online @ www.gahec.org Click “Search for a Course.” Click on the course you want to attend. Click on the link at the bottom of the page that says “Click Here To Register Online For This Event” where you are taken to a secure Online Registration Area. Type in your last name and last 4 digits of your social security number and follow the remaining steps.

Greensboro AHEC

2. FAX registration form to: 336-832-7591 3. MAIL to: Greensboro AHEC, 1200 N. Elm St., Greensboro, NC 27401-1020

Part of the North Carolina AHEC Program