Atls registration information
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ATLS REGISTRATION INFORMATION Name: ___________________________________ Title: MD____ DO ____ Other: _______ Resident: (circle one) Y N Specialty: ________________________________ Previous ATLS Course: Date ___________________ Location ____________________________________ Were you rated as having Instructor Potential? Yes ____ No ____ ATLS ID #:_____________________________ Street Address: (course materials will be mailed to this address) City, State, Zip: ______________________________ Daytime Phone: ______________________________ Fax Number: ________________________________ Email address: _______________________________ RegistrationRegistration is limited to 9 participants. The fee for the course is $500.00. KU Physicians – We will waive your course fee in exchange for teaching 1 full (2 day) course after you complete your instructor candidacy (student teaching does not count) You will receive course materials, breakfast, and lunch. Advanced
Trauma Life
Support® February 15-16, 2013 Instructor Course Schedule Sponsored by: Kansas Committee on Trauma American College of Surgeons in cooperation with Trauma Services University of Kansas Hospital 3901 Rainbow Blvd Kansas City, KS 66160 Course DescriptionThe Advanced Trauma Life Support Instructor Course is designed for physicians who have the qualifications and characteristics of an ATLS Instructor. Incorporated into the Instructor Course are teaching techniques designed to instruct participants in the specific educational philosophies, goals, and methods of teaching your peers in future ATLS Courses. In conjunction with the teaching techniques presented, you will be required to present a mini-lecture, teach specific skills procedures, and critique your colleague’s lecture and /or skills presentation. Medical content is not presented in this course as it is in the Student Course Prerequisite/Eligibility Requirements In order for an applicant to enroll in the ATLS Instructor Course, the participant must have taken the Student or Student/Refresher Course within the last three years and must have been identified as possessing instructor potential. The Course Director should have notified you if you were rated as having instructor potential. If you have questions regarding your eligibility, please call us and we can verify your eligibility. Objectives Upon completion of the ATLS course, the participant should be able to:
**MANDATORY FOR COURSE**: A copy of your current ATLS® Student card must accompany your enrollment application. Without it, we cannot accept your application. Course Location: Westwood Campus 2330 Shawnee Mission Parkway Westwood, KS 66205
To enroll, complete the entire course enrollment form and mail with a check payable to University of Kansas Hospital. Course material cannot be sent until the registration fee and enrollment form has been received. Course materials will be sent out 30 days prior to the course. SORRY, WE DO NOT ACCEPT CREDIT CARDS NOR CAN WE ACCEPT REGISTRATIONS BY PHONE. University of Kansas Hospital Trauma Services reserves the right to cancel the program due to insufficient enrollment. In this event, you will be notified and your entire registration fee refunded.
As an organization accredited for continuing medical education by the Accreditation Council for Continuing Medical Education (ACCME), the American College of Surgeons designates the 1.5 day ATLS Instructor Course as meeting the criteria for 15 credit hours in Category 1. RETURN WITH FEE TO: Trauma Services 3901 Rainbow Blvd Mail Stop 1011 Kansas City, KS 66160 Checks must be made out to University of Kansas Hospital In accordance with the Americans with Disabilities Act, pleas advise Trauma Services if you have any disability that requires special materials and/or services so that appropriate personnel can be advised. For more information contact the Trauma office: Office: (913) 945-6933, Fax: (913) 588-5219 TraumaEducation@kumc.edu Yüklə 63,5 Kb. Dostları ilə paylaş:
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