Registrant’s Name ___________________________________________________________________________________________ SPECIAL COURSES Fee ACMS Digital Diagnostic Quality Control Examination (DQC) (ACMS members only – See page 3 for details) $50.00 Digital DQC Exam for current Fellows-in-Training No Charge Fellows-in-Training Hands-on Cutaneous Flap Workshop $75.00 Fellows-in-Training Mohs Surgery & Histotechnology Lab Setup Workshop $75.00 Hand & Nail Workshop (ACMS members only — see page 13 for details) $375.00 Special Courses Total $ MORNING MINI-SESSIONS $55.00/Each session* Thursday, May 6 – 7:00 to 8:15 am 103.1 Tightening up your Takedowns: Improving outcomes with multi-stage repairs 103.2 Fellows-in-Training/Young Surgeons Practice Startup Pearls for Private, Group, and Academic Practice 103.3 Eyelid Reconstruction: From practical anatomy to repairing full thickness defects Indicate preferred course number and alternate choice(s):
1. 2. 3.
103.4 Understanding New Technologies and their Impact on Our Practice 103.5 Tumors in Skin of Color: Presentation and management considerations Friday, May 7 – 7:00 to 8:15 am 202.1 Pearls for Running an Efficient Mohs Laboratory 202.2 Pearls for Nail Surgery 202.3 Mohs for Melanoma: Technique, immunostaining, and tips for success 202.4 International Perspectives on Mohs Surgery 202.5 Multi-subunit Reconstruction Saturday, May 8 – 7:00 to 8:15 am 302.1 Perfecting Paramedians: Two and three-stage nasal repair 302.2 Using Cartilage to Improve Your Repairs 302.3 Reconstruction of the Ear 302.4 Frozen Section Mimickers 302.5 Pearls and Pitfalls for the Early Career Mohs Surgeon
Indicate preferred course number and alternate choice(s):
1. 2. 3.
Indicate preferred course number and alternate choice(s):
1. 2. 3.
Morning Mini Total
$
SUBTOTAL FROM PAGE 1 OF REGISTRATION FORM
$
TOTAL FEES PAID $ Payment may be made by check or credit card. Check payments, payable to the ACMS, should be made in U.S. dollars only (allow 7 additional days for processing). Send checks and completed registration form to ACMS, 2021 Annual Meeting Registration, 555 East Wells Street, Suite 1100, Milwaukee, WI 53202.
For credit card payments: Print name as it appears on card _______________________________________________________________________________ Visa MasterCard American Express Discover
Card #:_________________________________________________________________________________Expiration date: ___________________________
Signature _______________________________________________________________________________________________________________________ Registrations paid by credit card may either be mailed to the ACMS, 2021 Annual Meeting Registration, 555 East Wells Street, Suite 1100, Milwaukee, WI 53202, or faxed (make sure both sides of form are faxed) to (414) 276-2146. For questions about registration, please call (414) 347-1103 or email info@mohscollege.org. Cancellations before end of day March, 1, 2021 will be refunded all registration fees minus a $200.00 administration fee. Refunds will not be given after that date.
28
2021 ACMS Annual Meetings Hyatt Regency Seattle, Seattle, WA • Thursday, May 6 – Sunday, May 9, 2021
Made with FlippingBook HTML5