2014 PA Veterans Forum - University of Pittsburgh€¦ · 2014 PA Veterans Forum. Page 2 ......

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Community and Connections November 18-19, 2014 Holiday Inn Harrisburg/Hershey 604 Station Road Grantville, PA 17028 Funded by Department of Public Welfare Office of Mental Health and Substance Abuse Services Coordinated by Drexel University, Behavioral Healthcare Education Behavioral Healthcare Education 2014 PA Veterans Forum

Transcript of 2014 PA Veterans Forum - University of Pittsburgh€¦ · 2014 PA Veterans Forum. Page 2 ......

Community and Connections

November 18-19, 2014 Holiday Inn Harrisburg/Hershey

604 Station Road Grantville, PA 17028

Funded by

Department of Public Welfare Office of Mental Health and Substance Abuse Services

Coordinated by

Drexel University, Behavioral Healthcare Education

Behavioral Healthcare Education

2014 PA Veterans Forum

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Credit/Conference Information

Educational Objectives

By the completion of this conference, participants will be able to:• Will identify veteran specific initiatives from the PA Commonwealth

leaders;• Will cite important concepts of veteran post-traumatic growth;• Will review family issues experienced with re-integration post-

deployment;• Will recognize unique aspects of military culture;• Will name resources (employment, treatment, literature) for

veterans and their families.Target Audience• Veterans and Family Members of Veterans• Veterans Service Organizations • Behavioral Health Program Administrators and Clinicians• County Human Service Administrators• Professionals Involved in Working with Veterans

Credit Information

APA (Psychology): Drexel University College of Medicine, Behavioral Healthcare Education is approved by the American Psychological Association to offer continuing education for

psychologists. Drexel University College of Medicine, Behavioral Healthcare Education maintains responsibility for the program. This program is being offered for up to 10 hours of continuing education.

LSW/LCSW/LPC/MFT (PA SBSWE Licensed Social Workers in Pennsylvania): Drexel University College of Medicine is a preapproved provider of continuing education for Social workers and Clinical Social Workers. This program is being offered for 10 hours of continuing education.

NBCC (National Counselors): Drexel University College of Medicine is recognized by the National Board of Certified Counselors to offer continuing education for National Certified Counselors. We adhere to NBCC continuing education guidelines and can award a maximum of 10 hours of continuing education credit for this program.

PA Educators Act 48: Drexel University College of Medicine, Behavioral Healthcare Education is recognized by the Pennsylvania Department of Education to offer continuing education credits under Act 48 guidelines. Drexel University College of Medicine, Behavioral Healthcare Education adheres to Act 48 Continuing Education Guidelines. PA educators will receive 10 hours of credit for attending this complete program.

PCB (PA Certified Addiction Counselor (CAC), Certified Co-Occurring Disorders Professional (CCDP) and CCDP-D (Diplomate): Drexel University College of Medicine will award a maximum of 10 hours of PCB Approved Hours of Education for participants attending the conference. Our program is certified by the Pennsylvania Certification Board, Provider # 133.

PA Nurses: Drexel University College of Medicine, Behavioral Healthcare Education is an approved provider of continuing nursing education by the PA State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Participants will be awarded a maximum of 10 contact hours for attending this program.

CEU for all others: Drexel University College of Medicine/Behavioral Healthcare Education has been accredited as an Authorized Provider by the International Association

for Continuing Education and Training (IACET), 1760 Old Meadow Road, Suite 500, McLean, VA 22102. In obtaining this approval, Drexel

University College of Medicine/Behavioral Healthcare Education has demonstrated that it complies with the ANSI/IACET Standard which is widely recognized as the Standard of good practice internationally. As a result of their Authorized Provider accreditation status, Drexel University College of Medicine/Behavioral Healthcare Education is authorized to offer 1.0 IACET CEUs for its programs that qualify under the ANSI/IACET Standard.

CPRP: Drexel University College of Medicine/BHE is approved by the Psychiatric Rehabilitation Association (Provider #107) to sponsor continuing education for Certified Psychiatric Rehabilitation Practitioners. Drexel University College of Medicine/BHE maintains responsibility for the program and its content. This program is being offered for up to 10 hours of continuing education.

Conference Etiquette

It is difficult to maintain room temperatures that are comfortable for all participants. Conference attendees should be aware that room temperatures will vary throughout the conference center. A light sweater or jacket is helpful when room temperatures become too cool.

Participants are asked to turn off cell phones and beepers when attending a workshop, or to change them to a silent signal, if necessary. Please step outside of the room when responding to a page or a call.

ADA Accommodations

Individuals needing accommodations under ADA should contact the registrar at 215 831-4055.

Hotel Information

The conference will be held at the Holiday Inn Grantville. A block of sleeping rooms has been reserved at the hotel for a rate of $95.00 per night single/double occupancy. This special rate is only guaranteed until November 1, 2014 and does not include the 11% sales and occupancy tax. To make reservations, please call the Holiday Inn reservation desk at 1-866-379-7817. Be sure to mention PA Veterans Conference.

Driving Directions To Holiday Inn, Grantville

From New York/New Jersey

George Washington Bridge to I-80 West. Take 287 South, to I-78 West, to I-81 South. Located just off I-81, Hershey Exit 80. Right at top of ramp, and left into entrance.From Philadelphia

Take PA Turnpike 76. Get off at Exit 19 and take 283 North, to 83 North, to 81 North. Get off at Grantville Exit (Hershey Exit 80). Make left at top of ramp, and left into entrance.From Baltimore/Washington

Take I-83 North to I-81 North. Located just off I-81, Hershey Exit 80. Make left at top of ramp, and left into entrance.From Pittsburgh

Take PA Turnpike 76. Get off at Exit 16, follow signs to I-81 North, Hershey Exit 80. Make left at top of ramp, and left into entrance.

In order to accommodate as many attendees as possible, we are beginning the program at 10:30am on November 18, 2014 to allow participants to drive to the conference in the morning.

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Conference Registration

There is a $50 conference fee to register for this conference. Fee includes tuition, continental breakfast, refreshment breaks and a luncheon. Continuing education certificates are also included in the registration fee. Registration fee does not include overnight accommodations.

There will be paid scholarships to the first 50 Veterans who register for this conference. This scholarship will include all of the above noted amenities. These scholarships do not include overnight accommodations.

Refunds will be made up until five (5) working days prior to the conference minus a $35 administrative fee. All refund requests must be submitted in writing. Substitute attendees are permitted with approval from the Registrar prior to the conference.

A confirmation letter will be emailed to all registrations received with 5 working days prior to the conference.

Driving instructions are available on page 2 of this brochure.

RESOURCE INFORMATION TABLESThroughout the 2 day Forum, there will be resource tables geared for veterans, family members and professionals exhibiting throughout the conference.Please be sure to stop by each one and gather information, ideas and real-life benefits.

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Schedule at a Glance

TUESDAY, NOVEMBER 18, 2014

9am Registration10:20am – 10:30am Welcome and Announcements10:30am – 10:45am Color Guard – Wilson High School JROTC 10:45am – 12:15pm Plenary Session I – PA Leadership Panel

DAG Jerry G Beck, Jr., BG, USA, Ret. Department of Military & Veterans Affairs; Jean Bennett, SAMHSA Regional Administrator, Region 3; BG Carol A Eggert, Assistant Adjutant General, Army; Secretary Bev Mackereth, Department of Public Welfare; Scott A Rainey, Chairman, State Civil Service Commission; Secretary Gary Tennis, Department of Drug & Alcohol Programs; Secretary John Wetzel, Department of Corrections

12:15pm – 1:30pm Lunch1:30pm – 3:00pm Concurrent Session I - T01 – T053:00pm – 3:15pm Break3:15pm – 4:45pm Concurrent Session II -T10 – T14

WEDNESDAY, NOVEMBER 19, 2014

9:00am – 9:15am Welcome and Announcements9:15am – 10:15am Plenary Session II - “Post Traumatic Growth”

Richard Tedeschi, PhD10:15am – 10:30am “We Come Home”10:30am – 10:45am Break 10:45am – 12:15pm Plenary Session III – Veterans and Family Members Panel

Kevin Amann, USA, OIF; Carrie Amann, Spouse; Liz Graybill, USA, Desert Storm/Desert Shield, Spouse; Doug Graybill, USMC, Viet Nam; Dennis Hughes, Viet Nam; Talmadge (Jack) Riley, USA

12:15pm – 1:30pm Lunch 1:30pm – 3:00pm Concurrent Session III - W20 – W243:00pm – 3:15pm Break3:15pm – 4:45pm Concurrent Session IV - W30 – W334:45pm Evaluations, CE Validation and Adjournment

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Information on Plenary Presenters

Dr. Tedeschi received his BA in Psychology from Syracuse University, his PhD in Clinical Psychology from Ohio University, and completed his Clinical Psychology Internship at The University of North Carolina School of Medicine. Dr. Tedeschi is Professor of Psychology at the University of North Carolina at Charlotte, where he teaches personality and psychotherapy, and serves as Graduate Coordinator for the Clinical-Community Psychology program. He is a Licensed Psychologist specializing in bereavement and trauma. With his colleague Lawrence Calhoun, he has published books on posttraumatic growth, an area of research that they have developed that examines personal transformations in the aftermath of traumatic life events. Their books include Trauma and Transformation (1995), Posttraumatic Growth (1998), Facilitating Posttraumatic Growth (1999), Helping Bereaved Parents: A Clinician’s Guide (2004), and the Handbook of Posttraumatic Growth (2006). Dr. Tedeschi serves as a consultant to the American Psychological Association on trauma and resilience, and as a subject matter expert for the US Army’s Comprehensive Soldier Fitness Program.

PA Leadership Panel DAG Jerry G Beck, Jr., BG, USA, Ret. Department of Military & Veterans Affairs Jean Bennett, SAMHSA Regional Administrator, Region 3 BG Carol A Eggert, Assistant Adjutant General, Army Secretary Bev Mackereth, Department of Public Welfare Scott A Rainey, Chairman, State Civil Service Commission Secretary Gary Tennis, Department of Drug & Alcohol Programs Secretary John Wetzel, Department of Corrections

Veterans and Family Members Panel Kevin Amann, USA, OIF Carrie Amann, Spouse Liz Graybill, USA, Desert Storm/Desert Shield, Spouse Doug Graybill, USMC, Viet Nam Dennis Hughes, Viet Nam Talmadge (Jack) Riley, USA

Dale Adair, MD DPW/OMHSAS

Carrie Amann PA DOC

Sister Nancy DeCesare, PhD The Soldiers Project

Damon Frantz, K CTR NG PAANG (US) PA National Guard

Jeffrey Geibel PA DDAP

Stephanie Grimes Army OneSource

CONFERENCE COMMITTEERichard Hamp PA DMVA

Leslie Hoover The Soldiers Project

Jeff Kazlauskas PA Governor’s Office

Virginia Mastrine DPW/OMHSAS

Donna N McNelis, PhD Drexel University

Terence Moloney DPW/OMHSAS

Lynn Patrone DPW/OMHSAS

Scott Rainey State Civil Service Commission

Steven Sayers, PhD Philadelphia VA Medical Center and University of Pennsylvania

Natalie Shafer DPW/OMHSAS

Jessica Penn Shires DPW/OMHSAS

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Veterans Conference 2014Community and Connections

Tuesday - November 18, 2014

10:20 am – 10:30am Welcome and Announcements

10:30am – 10:45am Color Guard – Wilson High School JROTC

10:45am – 12:15 pm Plenary Session I PA Leadership PanelDAG Jerry G Beck, Jr., BG, USA, Ret. Department of Military & Veterans Affairs;Jean Bennett, SAMHSA Regional Administrator, Region 3;BG Carol A Eggert, Assistant Adjutant General, Army;Secretary Bev Mackereth, Department of Public Welfare;Scott A Rainey, Chairman, State Civil Service Commission;Secretary Gary Tennis, Department of Drug & Alcohol Programs;Secretary John Wetzel, Department of Corrections

12:15pm – 1:30pm Lunch

Concurrent Session I 1:30pm – 3:00pm

T01 - WRAP for VeteransJoseph Kozak, CPS, Former Director of Peer Support Services, Greater Reading Mental Health Alliance

in Berks County, Certified WRAP facilitator.The Wellness Recovery Action Planning (WRAP) is a structured program to assist the journey toward recovery from mental illness and/or co-occurring disorders. Designed to promote an optimum level of wellness, a WRAP helps a veteran monitor and respond to the signs and symptoms that may trigger a relapse. Learn from a veteran with life experiences ways to develop and maintain the belief and awareness that change in the direction of wellness is possible. This session will demonstrate that people recover in various ways.

Conference Schedule

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T02 - Innovative Strategies for Working with Justice-Involved Veterans: A Demonstration of an Effective Treatment Intervention

Timothy Wynn, CPS, DBH&IDS, PhiladelphiaMichael Brown, BS, DBH&IDS, PhiladelphiaTom Wagner, BS, RHDChristina M Finello, JD, PhD, DBH&IDS, PhiladelphiaThis session will provide an overview of the Trauma Recovery and Empowerment Model (TREM) and its application to the veteran population. TREM is a trauma-specific group modality, which has been modified for veterans to incorporate issues pertaining to military culture, drug and alcohol use, and the judicial system. A simulated group session will demonstrate this approach. The panel will discuss how TREM groups can help veterans address trauma and help in their recovery.

T03/13 - Treating PTSD Using a Couple-Based Approach - 2 Parts - 1:30pm – 4:45pmSteffany J Fredman, PhD, Assistant Professor, Human Development and Family Studies, Pennsylvania

State UniversityThis presentation will describe the use of cognitive-behavioral conjoint therapy (CBCT for PTSD); an empirically supported couple therapy for post-traumatic stress disorder that simultaneously treats PTSD symptoms and enhances intimate relationship functioning. The presentation will include a rationale for incorporating significant others into treatment for PTSD, an explanation of the key behavioral and cognitive interventions of CBCT for PTSD, and explanations of which couples may be best suited for this intervention.

T04 - From War to Home: An Introduction to Military Cultural Competency Through the Stories of Iraq and Afghanistan War Veterans

Gala True, PhD, Center for Health Equity Research and Promotion, Department of VA &Research Assistant Professor, University of Pennsylvania, Perelman School of Medicine

Despite widespread support for returning veterans, many healthcare providers are unfamiliar with aspects of military culture, norms, and values that may influence individual veterans’ healthcare needs and preferences. Drawing on veterans’ photos and stories generated through a community-engaged research project, this presentation will provide an introduction to ‘military cultural competency’ through a patient-centered lens. The presenters will highlight veterans’ experiences of war-related injuries, views on barriers to treatment-seeking and ongoing engagement in care, and suggestions for how to build therapeutic rapport between veterans and healthcare providers.

T05 - Providing Veterans Services Against the Tide: A Specialized Veterans TrackRobert Csandl, MHS, LPC, Treatment Trends Inc.Jason Kamora, MA, Treatment Trends Inc.This workshop will describe the essential components of embedding a specialized veteran’s track into existing public sector addiction treatment services. The track identifies the unique challenges and emphasizes key elements of healing and recovery such as; mutual support, empowerment, self-help, social connectedness and veteran mentoring. The use of multiple approaches helpful to veterans’ healing are provided within levels of care not typically provided thru the VA.

3:00pm – 3:15pm – Break

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Concurrent Session II 3:15pm – 4:45pm

T10 - Beyond Military Culture, the Human Being Behind the UniformLTC Thomas J Stokes, ACSW, LCSW, BCD, RN, Private Practice and current member of the

US Army ReservesThe presentation provides in-depth insight into the challenges experienced by members of the modern military and their families in today’s highly fluid and dynamic service environment. This session will detail the current military community and assist attendees to engage with and connect to today’s warriors and their families. The presentation is also designed to stimulate the thought process of the audience in relation to existing interventions used to assist veterans in order to create additional viewpoints to supplement the effectiveness of behavioral health providers and others. These observations are based upon lessons learned from the experience of the presenter while serving as a military social worker and from his highly successful combat tour as a behavioral health professional in Afghanistan from 2010 through 2011.

T11 - Innovative Housing and Employment ProgramsAl Mercer, MS, Veterans Leadership Program of Western PAMichelle Margittai, Veterans Leadership Program of Western PAThe Veterans Leadership Program of Western Pennsylvania, Inc. (VLP) is a nonprofit organization that serves 2,200 veterans annually by providing assistance with housing, employment and essential services. Representatives of VLP will describe two innovative, multi-sector programs that provide 1) emergency housing and services for female veterans and veterans with children; 2) employment services to “job-ready” and “career-minded” veterans seeking employment with salaries ranging from $25,000 to $100,000/year.

T12 - Soul Care; A Journey Toward the Healing of the Wounded SoulCol. David Smith, MDiV, MSSA, MS (Ret), Just PeaceThe battlefield becomes a test of the soul as warriors confront the horrors of war. Some will be physically wounded. Others will experience the invisible wounds of mind and spirit. Healing the wounded soul is an underserved component of veteran well-being. This session will include discussion of the literature on the benefits of spiritual grounding; introduce the participant to the realities of spiritual trauma experienced in combat; and explore strategies and resources for soul care to include integrating faith-based communities process for state civil service job titles with an emphasis on veterans’ preference

T13 – Part 2 - Treating PTSD Using a Couple-Based ApproachSteffany J Fredman, PhD, Assistant Professor, Human Development and Family Studies,

Pennsylvania State UniversityThis presentation will describe the use of cognitive-behavioral conjoint therapy (CBCT for PTSD); an empirically supported couple therapy for post-traumatic stress disorder that simultaneously treats PTSD symptoms and enhances intimate relationship functioning. The presentation will include a rationale for incorporating significant others into treatment for PTSD, an explanation of the key behavioral and cognitive interventions of CBCT for PTSD, and explanation of which couples may be best suited for this intervention.

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T14 - Veterans: Don’t Reintegrate, Rebuild AmericaChad Grills, BA, Army Infantry Veteran Author of Future Proof and Veterans: Don’t Reintegrate,

Rebuild America.This workshop introduces the PRSE plan for veterans to achieve posttraumatic growth. The PRSE plan is a simple daily focus on: personal health (P), relationships (R), skills (S), especially building those that align with high demand employment, and entrepreneurship (E), not necessarily starting a business, but practicing identifying and executing on opportunities in their own lives.

Wednesday – November 19, 2014

9:00 am – 9:15am Welcome and Announcements

9:15am – 10:15am Plenary Session II – Richard Tedeschi, PhD “Post Traumatic Growth”

10:15am – 10:30am “We Come Home”

10:30am – 10:45am – Break

10:45pm – 12:15pm Plenary Session III – Veterans and Family Members PanelKevin Amann, USA, OIF; Carrie Amann, Spouse; Liz Graybill, USA, Desert Storm/Desert Shield, SpouseDoug Graybill, USMC, Viet Nam; Dennis Hughes, Viet Nam; Talmadge (Jack) Riley, USA

12:15pm – 1:30pm – Lunch

Concurrent Session III 1:30pm – 3:00pm

W20 - When Family Members Serve Too: Deployment & ReintegrationKimberly A Kick, LCSW, PhD, Boots on Ground Consulting, Inc.Lieutenant Colonel Jennifer Bantner, BS, Boots on Ground Consulting, Inc.Myrna McNitt, LCSW, Boots on Ground Consulting, Inc.This session provides information on the critical issues faced by military families and service members during deployment and reintegration. It is important for professionals to understand the stress experienced by military families at the time of deployment and the needs at the time of reintegration. Key policy issues on how the military works with the service person will help the participants understand practice interventions.

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W21 - The National Veteran Job Retention Survey: Examining Veteran Employee RetentionJennifer A Roseman, MA, CPSSS, VetAdvisor® ServicesVetAdvisor and Syracuse University’s Institute for Veterans and Military Families (IVMF) decided to gather data to better understand the causes that lead to veteran employee retention issues. In this session we will presents the results and findings of the national Veteran Job Retention Survey, including demographic trends, providing participants with the data collected and with the findings and conclusions reached by the IVMF research team and VetAdvisor.

W22 - Veterans Making a DifferenceDoug Graybill, USMC, VietnamLiz Graybill, BS, USA, Desert Storm/Desert Shield, spouseHusband and wife, both veterans, started a non-profit organization “Veterans Making a Difference” to help the homeless (veterans and non-veterans) and help veterans in need. Greater than 500 lunches a month are served to the homeless. Monthly stand downs are held where clothing and food are distributed to anyone in need. Veterans Making a Difference began the Showers for the Homeless program. This session will share the inspiration as well as details as to how veterans out there are making a difference in the poorest city by helping those most in need.

W23 - PTSD: A Systems-Centered® Perspective—Some Ways to Make Treatment More Acceptable and Effective*

Richard Ganley, PhD, CGP, Research Director, Systems-Centered Training and Research Institute, Trainer for The Soldiers Project, SE PA Branch, Bala Cynwyd, PA

Available evidence-based treatments for PTSD are effective, yet many veterans will not go for treatment, or drop out early; and many therapists even within the VA are reluctant to implement such treatment. A Systems-Centered approach uses mindfulness, pacing, contextual thinking, specific protocols (e.g., to overcome avoidance), and a strength-based model to increase the acceptability of treatment, weaken restraining forces against it, and help veterans develop the skills they need to take on the battles within—and win.

W24 - Combatting Information Fatigue: Health Information Resources for VeteransLydia Collins, MLIS, National Network of Libraries of MedicineVeterans and their families need reliable health information resources to locate health information that is sensitive and pertinent to their needs. This presentation will cover freely available resources from the National Library of Medicine (NLM) for finding information on general health conditions, mental health resources including those for post-traumatic stress disorder (PTSD), family issues, substance abuse, amputations, support groups and more. Additionally, this class will prepare participants to find and assess other veterans’ health resources.

3:00 pm – 3:15pm – Break

Conference Schedule

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Concurrent Session IV 3:15pm – 4:45pm

W30 - Enhancing Evidence-Based Practice with Military and Veteran Families: The Penn State Clearinghouse for Military Family Readiness

Keith R Aronson, PhD, Clearinghouse for Military Family Readiness, Penn State UniversitySandee Kyler, MS, Clearinghouse for Military Family Readiness, Penn State UniversityThe Clearinghouse for Military Family Readiness at Penn State University ([email protected]) provides free information on more than 800 evidence-based programs and practices that may have utility in the military family context. Live technical assistance to professionals working with military families who are interested in selecting, implementing, and/or evaluating evidence-based programs is also provided. In this presentation, we will describe how the Clearinghouse can work and assist you in your work with veterans as well as provide a live demonstration.

W31 - Walking The Tightrope: Combat, Convict, CadaverMichael O’Neill, MA, Norristown State Hospital –Regional Forensic Psychiatric CenterIraq and Afghanistan war veterans struggling with the anger and emotional outbursts of combat trauma are more than twice as likely as other veterans to be arrested for criminal behavior. Veterans Courts are now playing a significant role in addressing issues unique to recent military veterans. This session will show a fuller understanding of how veterans perceive and cope with civilian life and demonstrate this necessary step to prevent incarceration from becoming a treatment modality.

W32 - Living with Traumatic Brain Injury: Clinical Strategies and Evidence Based Practices

Jessica Chappell, MA, Main Line Rehabilitation AssociatesThis session will examine the most effective methods to improve outcomes for individuals with traumatic brain injuries. The functional application of evidence-based cognitive rehabilitation practices, including the metacognitive approach will be highlighted. Clinical focus areas will include remediating attention and memory and understanding the unique differences between PTSD and TBI. Special emphasis on the importance of providing these evidence based practices to survivors after they are discharged to their own home and community will be included.

W33 - A Primer for Veterans: Commonwealth of Pennsylvania Employment Opportunities and Process

Heather Jannetta, PA State Civil Service CommissionEmployment frequently is an issue for veterans. The workshop will include an overview of the PA State Civil Service Commission and information about the application, testing and hiring.

4:45pm – Overall Evaluation and Adjournment

Conference Schedule

This form should only be used if you do NOT have internet access.To register, please type or print clearly on this form and mail with payment. Duplication of this form is permitted.(Note: please be sure to fill out this form as you would like it to appear on your name badge and certi cate.)

PLEASE TYPE OR PRINT CLEARLY:Name __________________________________________________ Degree _____________________________Employed by __________________________________________________________________________________Title/Position ___________________________________ Department ____________________________________Work Address _________________________________________________________________________________City _________________________________________________________________ State ___________________Zip ______________________ Email Address* ______________________________________________________Day Phone: (____) ______________ Evening Phone: (____) ______________ Fax: (____) ______________Veteran: Yes No ____________*We require a valid email address in order for you to receive your certificate.

TYPE OF CREDIT DESIRED (Please check one) APA LSW/LCSW NBCC PA Act 48** PCB/CAC/CCDP/CCDP-D PSNA CEU CPRP

** Required for PA Act 48, Professional ID # _________________ Required for CPRP Certification # _______________

SPECIAL REQUESTS I require special assistance - please contact the Registrar at 215-831-4055

DAYS ATTENDING (Please check all that apply) Tuesday, November 18, 2014 Wednesday, November 19, 2014

WORKSHOP CHOICES (Please check your choices below and be sure to select an alternate workshop in case your 1st choice is full)Concurrent Session I: T01 T02 T03/T13 T04 T05 Alt: ___________________Concurrent Session II: T10 T11 T12 T13 pt2 T14 Alt: ___________________Concurrent Session III: W20 W21 W22 W23 W24 Alt: ___________________Concurrent Session IV: W30 W31 W32 W33 Alt: ___________________

PAYMENT - CONFERENCE FEE: $50.00 Enclosed is a check for the total amount of $ ______________

Please make checks payable to: Drexel University College of Medicine/BHE Please charge $ ___________ to my: Visa Mastercard Discover Card

Cardholder’s Name _____________________________________________________________________________Credit Card Number________________________________ Expiration Date_____________ Security Code_______

(3 numbers on back of card)Mail Registration Form to:

Registrar • Veterans • Drexel University College of Medicine/BHEFriends Hospital • P.O. Box 45357 • Philadelphia, PA 19124

Call: 215-831-4055 or toll-free 877-243-3033 for further information.Visit our website at www.drexelmed.edu/bhe to Register online.

You may register online by logging onto our website at www.drexelmed.edu/bhe and clicking on the Conferences link on the left hand side of the page. This will take you to the Veterans Conference page where you will be able to view the entire brochure and either click the link to register online.

Registration Form