Sports Medicine for the School Age Athlete On the Field _ Office

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					                 Registration Form                                                                                                                                                                                      Overview                                                       Continuing Education Credit
   Sports Medicine Symposium                                                                                                                                                           Sports Medicine for the




                                                                        Permit No. 1050
                                                                        Non-Profit Org.
                                                                                                                                                                                                                        This Sports Medicine collaboration brings together             Medical: The Children’s Hospital is accredited by the




                                                                          U.S. Postage

                                                                          Denver, CO




                                                                                                                                                         Early Registration Deadline
                                                                                                                                                                                                                        distinguished visiting faculty with faculty of




                                                                              PAID
                                                                                                                                                                                                                                                                                       Accreditation Council for Continuing Medical
August 7-8, 2008                 •                      Denver, CO
(Please list your name and organization as you would like them to                                                                                                                       School Age Athlete:             The Children’s Hospital and the University of Colorado
                                                                                                                                                                                                                        Denver. The day is designed with lectures and workshops
                                                                                                                                                                                                                                                                                       Education to provide continuing medical
                                                                                                                                                                                                                                                                                       education for physicians. The Children’s Hospital




                                                                                                                                                                July 21, 2008
appear on your name badge and/or participant list.)
                                                                                                                                                                                                                        of interest to orthopedists, athletic trainers, physical       takes responsibility for the content, quality, and
Name __________________________Credentials _____________                                                                                                                                On the Field & Office           therapists and other allied health professionals whose
                                                                                                                                                                                                                        practice includes sport injuries. Topics address a variety
                                                                                                                                                                                                                                                                                       scientific integrity of this CME activity.
                                                                                                                                                                                                                                                                                       The Children’s Hospital designates this educational
                                                                                                                                                                                         Based Management
Job Title ______________________________________________                                                                                                                                                                of pediatric and young adult orthopaedic sport disorders.
                                                                                                                                                                                                                                                                                       activity for a maximum of 14.0 AMA PRA Category 1
Organization __________________________________________
Address _______________________________________________
                                                                                                                                                                                                                        Objectives                                                     Credit(s)™ (7 hours each day). Physicians should
                                                                                                                                                                                                                                                                                       only claim credit commensurate with the extent of
City ______________________ State _______ Zip __________                                                                                                                                    August 7-8, 2008            Upon completion of this conference, participants should
                                                                                                                                                                                                                        be able to:
                                                                                                                                                                                                                                                                                       their participation in the activity.
Daytime Phone (______) ________________________________                                                                                                                                                                    •	 Exchange ideas with experts and peers in field and       Board of Certification (BOC): The Children’s Hospital is
Home Phone (______) __________________________________                                                                                                                                                                        office management of concussions.                        recognized by the BOC, Inc. to offer continuing education
                                                                                                                                                                                                                           •	 Identify and manage injuries under different field       for Certified Athletic Trainers. This program has been
Fax # (______) ________________________________________
                                                                                                                                                                                                                              conditions                                               approved for a maximum of 14 hours of Category A
E-mail _______________________________________________                                                                                                                                                                                                                                 continuing education. Certified Athletic Trainers are
                                                                                                                                                                                                                           •	 Identify potential complications of treatment and
I plan to attend (Please check all that apply):                                                                                                                                                                               assessment of fractures.                                 responsible for claiming only those hours actually
   Both Day Lectures/Workshop Lectures                                                                                                                                                                                    •	 Exchange ideas with experts and peers regarding          spent participating in the continuing education activity
  Lectures:        8/7/08 Only         8/8/08 Only                                                                                                                                                                          ATC’s in schools.                                        Others: If not collecting CME or BOC CEUs, a
  Workshops:  8/7/08 Only  8/8/08 Only                                                                                                                                                                                   •	 Diagnose and treat knee pain and injuries in athletes.   certificate of attendance will be provided for all other
Selection of Workshops (Choose one workshop per day/time):                                                                                                                                                                 •	 Diagnose and manage athletes with hip and back pain.     participants.
8/7/08 1:00  Reduction Techniques/Splinting                                                                                                                                                                               •	 Discuss heat illness: evaluation, management and
                Spine Boarding & C/S Mgmt                                                                                                                                                                                    prevention
          2:45  Reduction Techniques/Splinting                                                                                                                                                                            •	 Exchange ideas with experts and peers in game            For Further Information
                Spine Boarding & C/S Mgmt                                                                                                                                                                                    time medication management.                              If you require special services to accommodate a
8/8/08 1:00  Lower extremity imaging                                                                                                                                                                                      •	 Exchange ideas with experts and peers regarding          disability or need additional information, please contact




                                                                                          Sports Medicine Symposium
                Hip/Spine exam                                                                                                                                                                                               pain management.                                         Leslie Barnes-Berry, Conference Coordinator,
                Knee/Ankle exam                                                                                                                                                                                           •	 Exchange ideas with experts and peers regarding          (720) 777-6610 or e-mail barnes-berry.leslie@tchden.org
         2:45  Lower extremity imaging
                Hip/Spine exam                                                                                                                                                                Sponsored by:                  supplements.                                             in advance of the conference.
                                                                                                                                                                                                                           •	 Discuss ways to be prepared for on the field
                Knee/Ankle exam
Registration Fees:                  By 7/21 After 7/21                                                                                                                                    The Children’s Hospital and         emergencies.
                                                                                                                                                                                                                           •	 Identify and manage ankle injuries in young
All Professionals                                                                                                                                                                       University of Colorado Denver         athletes.
MDs, PhDs                             $250        $275
                                                                                                                                                                                                                           •	 Exchange ideas with experts and peers on how to
ATCs, PTs, RNs & Allied Health        $100        $125
                                                                                                                                                                                         Department of Orthopaedics

                                                                                                                                         www.thechildrenshospital.org
                                                                                                                                                                                                                              manage emergencies.
Amount enclosed ________________ Check # ______________



                                                                                                                                         www.cusportsmedicine.org
Visa/MC # ____________________________________________
                                                                                                                                                                                              Denver, Colorado          Location/Accommodations
Expires _____________________________________________                                                                                                                                                                   The conference and accommodations will be held at the
                                                                                                                                                                                                                        Four Points Hotel by Sheraton, 6363 Hampden Avenue,
                                                                                                                      Denver, Colorado

Print Cardholder Name _________________________________
                                                                                                                      August 7-8, 2008



Cardholder Signature ___________________________________
                                                                                                                                                                                                                        Colorado 80222. Please make reservations before
If using an agency credit card, prior authorization from the issuing                                                                                                                                                    July 21, 2008 to ensure availability. A block of rooms
bank is required as some cards have usage restrictions. There will be                                                                                                                                                   are being held, room rates for conference participants
an additional $25.00 fee to reprocess any declined credit card.                                                                                                                                                         are $105 for single and double occupancy per night.
           Return form and check made payable to:                                                                                                                                                                       Mention the Sport Medicine Symposium to receive the
                   The Children’s Hospital                                                                                                                                                                              discounted rate. Individuals will make their reservations
                   13123 E 16th Ave, B060
                      Aurora, CO 80045
                                                                                                                                                                                                                        directly with the hotel by calling (303)758-7000 or
       OR Fax registration with credit card payment to:                                                                                                                                                                 (866) 368-7764.
                       (720) 777-7268                                                                                                                                                                                   For directions contact the hotel, directions will also be
  Registration questions? Please call The Children’s Hospital
                                                                                                                                                                                                                        included with your confirmation letter.
         Orthopaedic Department at (720)777-6610.
Sports Medicine Symposium                                                                                     General Information                                            Faculty                                                 John Polousky, MD
                                                                                                                                                                                                                                       Assistant Professor, Orthopaedic Surgery
                                                                                                              Registration Information                                       John Baldea, MD                                           Surgical Director, Sports Medicine
                                                                                                              Registration Fees:            By 7/21 After 7/21               Primary Care Sports Medicine Fellow
                                                                                                                                                                                                                                       The Children’s Hospital
                                                                                                              All Professionals
Agenda                                                        Agenda                                          MDs, PhDs                      $250     $275
                                                                                                                                                                               University of Colorado Denver
                                                                                                                                                                                                                                     Sourav Poddar, MD
Thursday, August 7, 2008                                      Friday, August 8, 2008                                                                                         Mark Erickson, MD                                         Associate Professor
                                                                                                              ATCs, PTs, RNs & Allied Health $100     $125
7:15a.m. Registration, Breakfast, Exhibits                    7:15a.m. Registration, Breakfast, Exhibits                                                                       Chairman and Associate Professor
                                                                                                                                                                                                                                       Team Physician, University of Colorado Denver
                                                                                                              If using an agency credit card, prior authorization              Department of Orthopaedic Surgery
7:50     Opening Remarks                                      7:50     Opening Remarks                        from the issuing bank is required as some cards have             Medical Director, Spine Center                        Steve Portenga, PhD. MS
         Armando Vidal, MD, Co-Chair                                   John Polousky, MD, Co- Chair           usage restrictions. There will be an additional $25 fee          The Children’s Hospital                                 Director of Sports Psychology
         Eric McCarty, MD                                     8:00     Office Management of Concussion        to reprocess any declined credit card.                                                                                   Division of Athletics & Recreation
                                                                                                                                                                             Gaia Georgopoulos, MD                                     University of Denver
8:00     Managing an Emergency: Who’s in Charge?                       Aaron Provance, MD                     Early Registration Discount Deadline                             Associate Professor, Orthopaedic Surgery
         John Hill, DO                                        8:15     Hip Pain in the Young Athlete          The early registration deadline is July 21, 2008.                Medical Director, Orthopaedic Department              Aaron Provance, MD
8:20     Preparticipation Physical                                     Ernest Sink, MD                        Early registration with payment is encouraged since              The Children’s Hospital                                 Senior Instructor, Sports Medicine Program
         John Baldea, MD                                                                                      enrollment and housing will be limited. Participants                                                                     The Children’s Hospital
                                                              8:30     Back Pain in the Young Adult                                                                          John C Hill, DO FAAFP FACSM
8:40     On the Field Management of Concussion                         Mark Erickson, MD                      will be accepted in order of postmark. Written                   Associate Professor                                   Elisa Reid, ATC, PTA
         Shane Miller, MD                                                                                     confirmation will be sent upon receipt of your registration.     University of Colorado Denver                           Head Athletic Trainer
                                                              8:45     Fractures in the Young Athlete                                                                                                                                  Smoky Hill High School
9:00     Psychology of the Injured Athlete                             Gaia Georgopoulos, MD                  Cancellation Policy                                              Director of Primary Care Sports Medicine Fellowship
                                                                                                              Your registration fee will be refunded less a $25                                                                        Aurora, CO
         Steve Portenga, PhD                                  9:00     Ankle Injuries in the Young Athlete
                                                                                                                                                                             David James, PT MSPT OCS CSCS
                                                                                                              enrollment-processing fee if cancellation is requested           Physical Therapist                                    Miguel Rueda, ATC
9:20     Pain Management in the Athlete                                Michelle Wolcott, MD                                                                                                                                            Head Athletic Trainer
                                                                                                              by July 21, 2008. No refunds will be granted after this          Sports Medicine
         Sourav Poddar, MD                                    9:15     Apophysitis                                                                                                                                                     University of Colorado – Boulder
                                                                                                              date or for non-attendance; however, you may send a              The Children’s Hospital
9:40     Dermatologic Infections in the Locker Room                    Brooke Pengel, MD                                                                                                                                             Deborah Saint-Phard, MD
         Deborah Saint-Phard, MD
                                                                                                              substitute.                                                    Gwendolyn Kerby, MD
                                                              9:30     Supplements                                                                                             Assistant Professor, University of Colorado Denver      Associate Professor
10:00    Break (visit Exhibitors)                                      Andrew Gregory, MD                     Planning Committee                                             Scott Kissinger, DDS & Stephen Barker, DDS
                                                                                                                                                                                                                                       Director, Active Women’s Health,
                                                                                                              John Polousky, MD, Conference Co-Chair,                                                                                   CU Sports Medicine Program
10:20    The Collapsed Athlete                                10:00    Break (visit Posters and Exhibitors)                                                                    Southbridge Dentistry, Littleton CO
                                                                                                              Eric McCarty, MD, Brook K Pengel, MD,                                                                                    Dept. of Physical Medicine and Rehabilitation
         Andrew Gregory, MD                                   10:15    Anterior Knee Pain                                                                                      Team Dentist, NHL Colorado Avalanche
                                                                                                              Aaron Provance, MD, Armando Vidal, MD,                                                                                   Department of Orthopaedic Surgery
10:40    Dental Injuries in the Athlete                                David James, PT, MSPT, OCS, CSCS                                                                        Team Dentist, University of Denver Pioneers Hockey
                                                                                                              Conference Co-Chair, Bridget Thrower, ATC,                                                                               University of Colorado Denver
         Scott Kissinger, DDS & Stephen Barker, DDS           10:30    Patellar Instability                   Leslie Barnes-Berry, PRA, Coordinator.
                                                                                                                                                                             Aaron Leu, ATC                                          Ernest L. Sink, MD
11:00    Managing Injuries under Different Field Conditions            Paul Saluan, MD                                                                                         Athletic Trainer
                                                                                                                                                                                                                                       Assistant Professor, Orthopaedic Surgery
         Aaron Leu, ATC                                       11:00    ACL Injuries in the Young Athlete
                                                                                                              Distinguished Keynote Faculty                                    University of Denver
                                                                                                                                                                                                                                       Director, Hip of Program
11:20    Return to Sport                                               John Polousky, MD                      Andrew Gregory, MD, FAAP FACMS                                 Shane Miller, MD                                          The Children’s Hospital
                                                                                                                Associate Professor                                            Pediatric Sports Medicine Fellow
         Eric McCarty, MD                                     11:15    OCD                                                                                                                                                           Armando F. Vidal, MD
                                                                                                                Vanderbilt Sports Medicine Center                              University of Colorado Denver
11:40    “What’s in my Bag” – How to be Prepared for                   Paul Saluan, MD                                                                                                                                                 Assistant Professor
                                                                                                                Nashville, TN                                                Eric McCarty, MD                                          Sports Medicine & Shoulder Service
         on the Filed Emergencies                             11:45    ATC in the Schools
         Miguel Rueda, ATC                                                                                    Paul Saluan, MD                                                  Associate Professor                                     University of Colorado Denver
                                                                       Elisa Reid, ATC PTA                                                                                     Chief of Sports Medicine & Shoulder Surgery
                                                                                                                Assistant Professor                                                                                                    Team Physician, University of Colorado-Boulder
12:00p.m. Lunch (provided)                                    12:00 p.m. Lunch (provided)                                                                                      University of Colorado Denver
                                                                                                                Cleveland Clinic                                                                                                       Team Physician, University of Denver
1:00     Workshop                                                        Breathing Problems in Athletes         Cleveland, OH                                                  Head Team Physician, University of Colorado-Boulder
                                                                                                                                                                                                                                     Michelle Wolcott, MD
2:30     Break (visit Exhibitors)                                        Gwendolyn Kerby, MD                                                                                   Head Team Physician, University of Denver
                                                                                                                                                                                                                                       Assistant Professor
2:45     Workshops                                            1:00     Workshop                                                                                              Kimberly (Brooke) Pengel, M.D.                            University of Colorado Denver
                                                              2:30     Break (visit Exhibitors)                                                                                Medical Director, Sports Medicine                       Team Physician, Univ. of CO Denver & Univ. of Denver
4:15     Evaluation                                                                                                                                                            Assistant Professor
                                                              2:45     Workshops                                                                                                                                                     Stadium Medical
4:30     Adjourn                                                                                                                                                               The Children’s Hospital
                                                                                                                                                                                                                                       Emergency Medical Providers to:
Workshops: 1. On the field reduction techniques/splinting     4:15     Evaluation                                                                                                                                                      Denver Broncos, Colorado Avalanche, Denver
           2. Basics of spine boarding and C/Spine            4:30     Adjourn                                                                                                                                                          Nuggets, Univ. Of Colorado Athletics and
              management on the field                         Workshops: 1. Lower extremity imaging                                                                                                                                     Univ. of Denver Athletics
                                                                         2. Hip/spine exam
                                                                         3. Knee/ankle exam

				
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