registration form understanding memory loss: strategies for success VI Please photocopy this form for multiple registrations Name____________________________________________ Company_________________________________________ Address__________________________________________ City________________________St_______Zip___________ Daytime Phone ( A Napa Valley Education Conference for Family Caregivers and Professionals )_______________________________ E-mail Address____________________________________ q I would like a vegetarian lunch q I would like CEUs. My license type is: q RN q LVN q CNA/HHA q MFT q LCSW q RCFE License #:_________________________________________ Fees: Until November 14: ________ $35 General Registration ________ $55 Professionals (including CEUs) After November 14: ________ $40 General Registration ________ $60 Professionals (including CEUs) ________ Total Amount Enclosed Send registration form(s) along with check to: Alzheimer’s Association 1211 N. Dutton Ave., Suite A Santa Rosa, CA 95401 Credit Card Payment Continuing Education Units Please Note: Those requesting CEUs will not be allowed late arrival. Pre-registration is necessary, and obtainment of credits requires sign-in at the beginning of event, and sign-out and submission of an evaluation survey at end of day; no mailed evaluations will be accepted. Certificates will be mailed to participants after the conference. For health care professionals, this course has been approved by the California State Board of Registered Nurses (BRN), for RNs and LVNs– 6 hours, Provider No. CEP 12415; LCSW and LMFTs have been approved by the California Board of Behavioral Science – 6 hours, Provider No. PCE1121; CNA and HHA approved by the Department of Health Services – 6 hours, Provider No. 06329; RCFE pending approval by the Administrator Certification Program – 6 hours. 800.272.3900 www.alz.org/norcal Secure online registration at http://edconference.kintera.org/Napa2014 Northern California & Northern Nevada North Bay Area 1211 N. Dutton Ave., Suite A Santa Rosa, CA 95401 Please call the Alzheimer’s Association at 707.573.1210. Napa Education Conference - December 4, 2014 Payment by check Thursday, December 4, 2014 8:30 am to 4 pm Yountville Community Center 6516 Washington Street Yountville Napa Valley Hospice Adult Day Services Compassion. Dignity. Connection. Understanding Memory Loss: Strategies for Success VI Thursday, December 4, 2014 8:30 am to 4 pm Yountville Community Center 6516 Washington Street Yountville, CA agenda 7:45 am Registration & Continental Breakfast 8:30 am 8:45 am 9:45 am WELCOME & INTRODUCTIONS William Fisher, CEO, Alzheimer’s Association of Northern California & Northern Nevada ALZHEIMER’S DISEASE: THE LATEST UPDATES ON DIAGNOSIS AND TREATMENT Geoffrey A. Kerchner, MD, PhD, Assistant Professor of Neurology & Neurological Sciences, Stanford University School of Medicine The Alzheimer’s Association, in partnership with Napa Valley Hospice & Adult Day Services and the Town of Yountville, presents its sixth annual education conference in Napa Valley. Understanding Memory Loss: Strategies for Success VI is a six-hour conference for family members and professionals (continuing education units are available) that combines many topics relating to Alzheimer’s disease and dementia. We hope that you will join us for this outstanding program. 11:15 am QUESTION AND ANSWER DISCUSSION William Fisher facilitates an armchair discussion with Dr. Kerchner and Dr. Landsverk 12:00 pm Lunch (box lunch provided) 12:45 pm INSIGHTS INTO EARLY DEMENTIA Early Stage individuals share their experiences 1:30 pmBreak 1:45 pm Break 10:00 am MEDICATION MISMANAGEMENT: HOW MEDICATIONS AFFECT DEMENTIA & BEHAVIOR Elizabeth Landsverk, MD, ElderConsult Geriatric Medicine 11:00 amBreak General Registration Professionals (CEUs included) 2:45 pm SOMETIMES YOU GOTTA LAUGH Karen Stobbe, nationally recognized speaker in dementia care 4 pm Closing Remarks & Evaluations Homemakers/Caregivers to Nursing Services Caring for Infants to Grandparents (and All Ages In Between) SILVER Emeritus at Villa Del Rey Hired Hands Homecare Home Instead Senior Care Senior Helpers North Bay PARTNERS Area Agency on Aging serving Napa and Solano Napa Long-Term Care Ombudsman Redwood Caregiver Resource Center Rianda House Senior Activity Center presented by Six (6) Continuing Education Units available for the following: RN/LVN Provider #CEP12415 LCSW/MFT RCFE Administrator Provider #PCE1121 Application Pending $40.00 $60.00 WR NOTE: Refunds will be made only if request is received in writing by November 24, 2014. Registration Rates after November 14, 2014 General Registration Professionals (CEUs included) %RUQ $JH 2:30 pmBreak Fees include continental breakfast & lunch. $35.00 $55.00 GOLD STRESSBUSTERS! - WHO YA GONNA CALL? Deanna Randall, MSW, Alzheimer’s Association, and Tiffany Pippen, MSW, Family Caregiver Alliance registration information Early Bird Registration Rates (before or on November 14, 2014) sponsors CNA/HHA Provider #06329 Napa Valley Hospice Adult Day Services Compassion. Dignity. Connection.
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