REGISTRATION BROCHURE

REGISTRATION BROCHURE

2016 NATIONAL CONFERENCE THE SKY’S THE LIMIT: TRANSFORMING OUR FUTURE 2

PurposeThe Pediatric Endocrinology Nursing Society (PENS) is committed to the advancement of the art and science of pediatric endocrinology nursing. This includes the establishment and continued development of standards of practice, the enhancement of nursing research, the advancement of clinical expertise and the promotion of recognition of excellence in nursing practice.

Program DescriptionThe Annual Conference provides a forum for educational opportunities as well as a chance to interact with colleagues and experts in the field of pediatric endocrinology. The faculty will present information on a variety of pediatric endocrine disorders, as well as topics of general interest to nurses and other health care professionals. Teaching methods will include lectures, interactive sessions, discussions, workshops and poster sessions.

Target AudienceThe conference is designed for nurses and other health care professionals interested in recent developments in the field of pediatric endocrinology nursing, including pediatric diabetes.

Program GoalsIt is PENS’ goal to promote high quality endocrinology nursing practice through this educational offering. Conference participants receive the latest information in basic to advanced practice, experience and research as demonstrated by pediatric endocrinologists and pediatric endocrinology nurses.

Program Objectives Develop new skills to improve educational and patient

outcomes

Provide educational opportunities in pediatric endocrinology for nurses and others with expertise in the area

Promote the pursuit of nursing practice and research through a research presentation and poster session

Provide educational opportunities in the management and treatment of selected endocrine disorders

Provide direction for understanding health care changes

Objectives for each session are listed within the schedule

AccreditationApplication has been made to the Greater Kansas City Chapter of the American Society for Pain Management Nursing, an approved provider of continuing nursing education by the Kansas State Board of Nursing. Kansas State Board of Nursing provider number LT0279-0412.

Application has also been made to the Kansas Board of Pharmacy, an approved provider of continuing pharmacology hours. In order to receive contact hours for this conference, participants must complete the online evaluation.

NetworkingOne of the key benefits of attending the PENS Conference is the opportunity to develop and continue relationships with your colleagues through networking. Networking offers many tangible benefits to conference participants, including, but not limited to, validating your experience in providing nursing care and developing a better understanding of your practice and your role in care delivery by learning from others are dealing with similar circumstances, solving the same problems and confronting the same issues. Take advantage of this national gathering of pediatric endocrinology nurses to learn more about national issues and trends.

Message BoardPENS will provide a message board to facilitate networking. Bring with you to the 2016 National Conference job open-ings, questions and ideas to post for response by your PENS colleagues. If you have a special interest, arrange to meet others with that same interest.

PostersPENS is providing a venue for meeting attendees to view and discuss participants’ poster presentations on Friday evening. Visit with the poster presenters and learn about current research that will affect your clinical practice!

Meg Keil, PhD, CRNP, Chair

Rebecca Crespi, RN, MSN, CPNP

Cathy Metzinger, AAS, RN, CDE

Tamara Nenadovich, RN

Maryann Johnson, BSN, RN, Board Liaison

PENS Conference Planning Committee

REGISTRATION BROCHURE

2016 NATIONAL CONFERENCE THE SKY’S THE LIMIT: TRANSFORMING OUR FUTURE

Registration InformationEarly Registration: On or before March 22, 2016

Regular Registration: March 22 - April 27, 2016

Onsite Registration: After April 27, 2016

You will receive a confirmation letter approximately two weeks after receipt of your registration form. Confirmation letters will not be sent after April 27, 2016.

Payment must accompany the registration form. Registration forms received without payment will not be processed until payment is received.

Registration fees include the educational program, networking events, and all meal functions.

Cancellation & TransfersCancellations and transfers must be requested in writing and postmarked, faxed or emailed by April 27, 2016. Refunds will be issued following the conference. A $50 administrative fee will be assessed. Cancellation requests must include the reason for the cancellation. If you transfer your registration to another person, please include a completed registration form for that person with your written request. Requests for cancellation postmarked, emailed or faxed after April 27, 2016, are not refundable.

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Towering above the Mile High City, Denver Marriott City Center exceeds expectations with exceptional service and thoughtful amenities in a convenient location. This downtown Denver hotel boasts breathtaking views of the Rocky Mountains and city skyline and is near the Colorado Convention Center, 16th Street Mall, Coors Field, Pepsi Center, Sports Authority Field and Denver Art Museum. With farm-to-table dining at Prospect’s Urban Kitchen and Bar, a state-of-the-art fitness center, indoor pool and deluxe guest rooms with high-speed Wi-Fi and plush bedding, we make it easy for business and leisure travelers to relax and breathe in the fresh mountain air in style. Thrive during your stay at Denver Marriott City Center while tapping into all of downtown Denver’s high energy. Used with permission from the Denver Marriott City Center.

To prevent attendees from having to stay at an overflow hotel, participants will need to register for the conference to receive the hotel reservation link, which is provided on the confirmation page when registering online. If you register using the PDF form, once your completed form is received and processed, you will be sent a confirmation email with the link to make your hotel reservation.

Room rate: $164 plus tax per night single/double occupancy including guest room internet and complimentary fitness center access.

Reservation deadline: Book by Tuesday, April 19, 2016 to receive group room rate.

Please note if your conference registration is submitted after April 19, 2016 this does not guarantee the group rate at the hotel. To ensure you receive the group rate, please turn in your registration before April 19, 2016.

HOTEL INFORMATION

TRANSPORTATION INFORMATIONThe Denver Marriott City Center is located 26 miles from the Denver International Airport.

Taxi – Taxis are approximately $60.00 one-way.

RTD Commuter Rail – In April 2016 Denver RTD will open a new rail line from the Denver International Airport to Union Station in Downtown Denver. Union Station is located approximately 10 blocks from the Denver Marriott City Center and just one block from the FREE 16th St. Mall Shuttle that will drop you off 1 block from the Marriott. One way service on the RTD Rail will be $9.00 one way. For more information on the RTD Rail and rate information please visit their website at www.rtd-denver.com.

Shuttle Service – Super Shuttle is offering PENS Attendees a discount on round-trip service from the Denver International Airport. The special PENS rate is $38 and reservations are required. To make reservations online please visit https://reservations.supershuttle.com and use the Code: JTY9C.

Denver Marriott City Center

1701 California St. Denver, CO 80202

REGISTRATION BROCHURE

2016 NATIONAL CONFERENCE THE SKY’S THE LIMIT: TRANSFORMING OUR FUTURE

CONFERENCE PROGRAM SCHEDULE

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Thursday, May 12, 20168:00 a.m. - 5:00 p.m. H.A.N.D.S.SM Pre-Conference Workshop

This workshop requires separate registration and additional fee. If the workshop does not achieve minimum registration, it is subject to cancellation. If cancelled, registration fees will be refunded in full.

Summarize current knowledge and guidelines related to diabetes and diabetes management at school. Identify the school nurse’s role in developing and maintaining a student’s individualized healthcare plan for safe, effective diabetes

management at school. Describe the management of hypoglycemia and hyperglycemia at school.

H.A.N.D.S.SM is a one-day educational program developed by the National Association of School Nurses (NASN). Course materials include a H.A.N.D.S.SM Participant Manual and numerous resources to support school nursing practice as it relates to diabetes management in school-aged pupils. The NASN-approved education program is available here. A completed evaluation and full day attendance are required to receive 6.5 CE contact hours.

4:30 - 5:30 p.m. New Member & Past Presidents Reception

5:30 - 7:30 p.m. Welcome Reception in Exhibit Hall

7:30 - 10:30 p.m. Evening Event at the Denver Athletic Club -- Sponsored by Lilly Join your PENS colleagues for a truly unique Denver dining experience. Enjoy Denver Athletic Club’s rooftop deck with a view of the Rocky Mountains, downtown Denver like you’ve never seen before and crisp mountain air. You will enjoy one-of-a-kind Denver bites, local brews and local wines while networking and relaxing under the stars.

Friday, May 13, 20167:00 - 7:45 a.m. Breakfast

7:45 - 8:00 a.m. Welcoming and Opening Remarks Maryann Johnson, BSN, RN, PENS President

8:00 – 9:00 a.m Opening Keynote Address: Compassionate Care of Those Who Suffer from Addictive Disorders Donna White RN, PhD, CS, CADAC

Define types of addictive disorders. Discuss principles of addictive treatment. Describe types of intervention and treatment.

9:00 – 10:00 a.m. GENERAL SESSION 1: Metabolic Effects of Growth Hormone (GH)

Describe the effects of GH on the metabolism of glucose, protein and fat under normal and pathologic conditions.

Explain the difference between the metabolic effects of GH deficiency or excess from those of IGF-I deficiency or excess.

Discuss how to apply this information in counselling and management of patients on GH therapy.

Mark Sperling, MD

10:00 -10:30 a.m. Break in Exhibit Hall

10:30 – 11:30 a.m. GENERAL SESSION 2: Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children

Identify which babies to screen for hypoglycemia. Describe how to investigate a baby with suspected hypoglycemia. Explain the treatment of neonatal hypoglycemia.

Paul Thornton, MD

11:30 a.m. - 12:30 p.m. GENERAL SESSION 3: Hypogonadism in Adolescents: Approach to Treatment and Transition to Adult Care

Describe the variation in pubertal timing. Identify ways to implement a more patient centered approach to adolescents with pubertal disorder. Analyze what steps can be taken to enhance/improve transitional care in their practice.

Andrew Dwyer, PhD, FNP-BC

REGISTRATION BROCHURE

2016 NATIONAL CONFERENCE THE SKY’S THE LIMIT: TRANSFORMING OUR FUTURE

CONFERENCE PROGRAM SCHEDULE

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12:30 – 2:00 p.m. Luncheon with Exhibitors

2:00 – 3:00 p.m. Concurrent Session 1A: Islet Cell Transplantation DM/ADV

Define islet allo-transplantation. Describe specific indications for islet allo-transplantation. Discuss the limitations to islet allo-transplantation and the future directions of research.

Gregory P. Forlenza, MD, MCR

2:00 – 3:00 p.m. Concurrent Session 1B: Updates in Endocrine Pharmacology for the APN PHARM/ADV

Discuss advanced drug treatment plans for endocrine patients. Describe drug therapies currently available for difficult diabetes cases. Identify the benefits of new drugs on the horizon for both endocrine and diabetes patients.

Dana Greer, APRN, CPNP, CDE

2:00 – 3:00 p.m. Concurrent Session 1C: Organized Approach to Pumping (with and without Continuous Glucose Monitoring System (CGMS)) and Pump Data Analysis Workshop

DM/BAS

Describe the four (4) step approach to pump training. Identify the timing of when to add the CGMS. Recognize trends in pump and CGMS downloads.

Mako E. Sather, RN, MSN, CPNP

3:00 – 3:30 p.m. Break in Exhibit Hall

3:30 – 4:30 p.m. Concurrent Session 2A: Pediatric Thyroid Nodules and Differentiated Thyroid Cancer: Exploring the New Management Guidelines

ENDO/ADV

Describe the importance of the inaugural pediatric specific American Thyroid Association (ATA) management guidelines and how these guidelines may impact healthcare delivery.

Identify key features of clinical presentation of pediatric thyroid nodules and differentiated thyroid cancer. Describe the treatment and long-term outcomes of children with papillary thyroid cancer (PTC).

Sarah J. Bottomley, MSN, RN, CPNP; Angela R. Yarbrough, MSN, RN, FNP-BC

3:30 – 4:30 p.m. Concurrent Session 2B: Cystic Fibrosis-Related Diabetes (CFRD) DM/ADV

Describe pathophysiology and diagnosis of Cystic Fibrosis-Related Diabetes (CFRD). Explain management goals of CFRD. Discuss collaboration between Endocrine, Pulmonary, Gastroenterology, and Psychology services.

Shayne Dougherty, MSN, CRNP

3:30 – 4:30 p.m. Concurrent Session 2C: Beyond the ‘mones: The Art of Transgender Care with Youth

ENDO/BAS

Describe a welcoming approach to transgender and gender expansive youth. Identify the ways in which transgender youth express themselves in their transition. Discuss ways to support and affirm a young person and their adult caregivers as they transition.

Joanne M. Goodall, CRNP

3:30 – 4:30 p.m. Concurrent Session 2D: Linear Growth Assessment: Evaluation, Causes and Treatment of Growth Failure

ENDO/BAS

Describe the steps in accurate growth assessment. List the causes of growth failure. Explain the treatment of growth disorders.

Terri Lipman, PhD, CRNP, FAAN

4:30 – 5:30 p.m. Concurrent Session 3A: Testotoxi-WHAT? Overview of Diagnosis and Treatment of Testotoxicosis

ENDO/ADV

Identify the diagnostic criteria for testotoxicosis. Explain the difference in diagnosis of central precocious puberty from adrenal issues. Discuss various drug therapies for testotoxicosis and potentially the treatment for central precocious puberty.

Janet L. Moore, MSN, RN, CPNP

4:30 – 5:30 p.m. Concurrent Session 3B: Septo Optic Dysplasia in Children ENDO/BAS

Describe and define septo optic dysplasia. Explain the difference between typical child development to that of children who are visually impaired. Discuss pituitary hormone needs in children with septo optic dysplasia.

Kathryn Clark, PPCNP-BC

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4:30 – 5:30 p.m. Concurrent Session 3C: The Path from Hormone Abnormality to Hypoglycemia

DM/ADV

Discuss the human body systems required for normal fasting adaptation. Describe how hormone abnormalities can lead to hypoglycemia. Discuss case studies of infants and children with hypoglycemia and determine which hormone(s) could be

implicated as a cause of hypoglycemia.

Linda Steinkrauss, RN, MSN, CPNP

5:30 – 7:00 p.m. Poster Reception in Exhibit Hall

7:30 - 10:30 p.m. Evening Event at Lucky Strike Denver -- Sponsored by EMD Serono Get your dancing and bowling shoes ready for rocking good time at Lucky Strike Denver. With a tantalizing menu of chef driven cuisine, hand-crafted cocktails, and a live local DJ, Lucky Strike Denver breathes new life into the typical bowling experience with chic modern decor and a one-of-a-kind atmosphere.

Saturday, May 14, 20168:00 - 9:00 a.m Awards Breakfast

9:00 - 10:00 a.m. Keynote: Professional Development: From Here to There and in Between Cecily Betz, PhD, RN, FAAN

10:00 – 10:15 a.m. Break

10:15 - 11:15 a.m. GENERAL SESSION 4: Research Oral Presentations

Development and Psychometric Testing of the Neonatal Growth Measurement Survey Screening for Retinopathy in Children and Adolescents with Diabetes Mellitus (DM) Development of a Pediatric Screening Tool for Diabetic Peripheral Neuropathy

Jan M. Foote, DNP, ARNP, CPNP; Erika McCann, RN, BS, BSN, MS; Joanne T. Moser, MSN, CRNP

11:15 a.m. - 12:15 p.m. GENERAL SESSION 5: Bionic Pancreas: From Dream to Realization

Identify the challenges that must be met to automate control of blood glucose levels in people with type 1 diabetes.

List the elements of an automated closed-loop bionic pancreas. Describe the results of a recent clinical study of closed-loop blood glucose control using subcutaneous

delivery of insulin and glucagon.

Scott Scolnick, M.Ed.

12:15 – 1:30 p.m. Membership Meeting/Lunch

1:30 – 2:30 p.m. Concurrent Session 4A: Writing for Publication ALL/BAS

List the knowledge and skills necessary for writing for newsletters, journals, and other nursing related publications.

Identify a potential topic for publication based on your area of clinical expertise. Identify potential organizational resources within the work setting that can be accessed to achieve your

publication goal.

Cecily Betz, PhD, RN, FAAN

1:30 – 2:30 p.m. Concurrent Session 4B: Endocrine Advanced Practice Nurse Case Studies ENDO/ADV

Bone Disorder as a Result of Zolendronate Treatment for OI Gene Mutation Vitamin D: How Much, How Often and What Formulation Works the Best? Hyperinsulinism: Beyond the Naked Eye Update - a Rare Form of HI Found to Have Only Mutations in the

Pancreatic Tissue

Wendy Schwarz, RN; Eileen Pyra, RN, MN; Vivian Enyo Dzata, MSN, CRNP

1:30 – 2:30 p.m. Concurrent Session 4C: Diabetes Advanced Practice Nurse Case Studies DM/ADV

Ten Dogs, An Elevated HbA1c and Severe Hypoglycemia: An Autoimmune Endocrine Story Scaring the Dermatologist: A look at Xanthoma in Diabetes Taking the Leap: A Patient’s Journey to Adult Care

Melissa Rearson, MSN, CRNP; Shari Liesch, APNP, CDE; Mandi Cafasso, DNP, RN, CNP

CONFERENCE PROGRAM SCHEDULE

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2016 NATIONAL CONFERENCE THE SKY’S THE LIMIT: TRANSFORMING OUR FUTURE 7

2:30 - 2:45 p.m. Break

2:45 – 3:45 p.m. Concurrent Session 5A: Endocrinopathies Related to Cancer Therapy ENDO/ADV

Describe the endocrine sequelae of childhood cancer therapies. Discuss the common risk factors for developing endocrionpathy after cancer treatment. Explain guidelines for monitoring, diagnosis and treatment.

Angela R. Yarbrough, MSN, RN, FNP-BC; Sarah J. Bottomley, MSN, RN, CPNP

2:45 – 3:45 p.m. Concurrent Session 5B: Central Precocious Puberty: To Treat or Not to Treat and Other Clinical Dilemmas

ENDO/BAS

Describe potential pharmacologic options for treating patients with central precocious puberty and identify appropriate use of these medications.

Discuss current practice styles and potential ways to either maintain or change their current styles based on current research data.

Megan Lessig, MSN, CRNP

2:45 – 3:45 p.m. Concurrent Session 5C: Sweet Bouncing Baby on Insulin: Transient Neonatal Diabetes Mellitus

DM/ADV

Identify and define neonatal diabetes. Describe the difference between transient neonatal diabetes vs. permanent neonatal diabetes. Describe the complexity of transition to pump and use of diluted insulin. Explain the barriers to transitioning this patient from hospital to home. Discuss how to apply new knowledge to future care of new onset diabetes patient and family centered care.

Shannon Abernethy, RN, CPN

2:45 – 4:15 p.m. Concurrent Session 5D: Ready, Set, Research! ALL/BAS

Identify a clinical problem. Investigate what is already known about this clinical problem. Create an idea and form a research question to address the problem. Design a research project. Develop a plan on how to execute the project and obtain potential funding.

Carol Howe, PhD, RN, CDE; Sharron Close, PhD, MS, RN, CPNP-PC; Terri Lipman, PhD, CRNP, FAAN; Meg Keil, PhD, CRNP

4:30 – 5:30 p.m. Committee Meetings: Conference Planning Committee Education Committee - open to new members Nominating Committee Research Committee - open to new members

7:30 - 10:30 p.m. Evening Event -- Sponsored by Novo Nordisk Enjoy a fun, relaxing evening enjoying tasty eats, delicious drinks and one-of-a-kind entertainment – all without leaving the hotel! The music won’t stop until 10:30 pm and the food and bars will continue to flow. This event will have you dancing until your feet ache – luckily you will be just an elevator ride away!

Sunday, May 15, 20168:00 – 9:00 a.m. Leadership Breakfast

9:00 - 10:00 a.m. Keynote: Fundraising Best Practice Tips Tom Karlya, BA, Diabetes Dad

Identify areas of fundraising not typically distinguished during the course of usual work-place activities. Explain the strategy for fundraising that will establish projects and programs in the participants’ schools. Discuss fundraising best-practices learned through both lecture and role playing exercises.

10:00 - 10:15 a.m. Break

CONFERENCE PROGRAM SCHEDULE

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2016 NATIONAL CONFERENCE THE SKY’S THE LIMIT: TRANSFORMING OUR FUTURE 8

10:15 – 11:15 a.m. Concurrent Session 6A: Pseudohypoparathyroidism: Case Presentation and Literature Review

ENDO/ADV

Identify signs and symptoms of pseudohypoparathyroidism. Identify methods of properly diagnosing pseudohypoparathyroidism. Explain the underlying genetics of pseudohypoparathyroidism.

Aristides K. Maniatis, MD, FAAP

10:15 – 11:15 a.m. Concurrent Session 6B: Exploring the Benefits of Pump (& Sensor) Therapy When Steroids Are Needed

DM/ADV

Explain the differences between insulin action times for multiple daily injections (MDI) and insulin pump therapy.

Discuss sick care using separate basal pattern for illness, temporary basal, and sensor. Explain the benefits to pump therapy as related to overall quality of life.

Shari Liesch, BSN, APNP, CDE

11:15 a.m. - 12:15 p.m. Concurrent Session 7A: Autoimmune Endocrine Disorders: Who and How to Evaluate - A Case Based Discussion

ENDO/ADV

Describe the screening guidelines for autoimmune endocrine disorders in patients with type-1 diabetes, Down syndrome and Turner syndrome.

Identify clues in the history and physical examination that would lead to further testing for autoimmune endocrine disorders.

Discuss laboratory evaluation for autoimmune endocrine disorder.

Jennifer M. Barker, MD

11:15 a.m. - 12:15 p.m. Concurrent Session 7B: Thyroid Cancer: It’s Not Just for Adults ENDO/BAS

Describe the clinical presentation of thyroid cancer in children and young adults. Discuss the clinical course and management of thyroid cancer in children. Explain the follow-up management of thyroid cancer in children.

Elaine Pottenger, MS, RN, CPNP, PMHS; Deborah Diotallevi, MS, RN, CPNP; Amelia DeRosa, BSN, RN, CPON

12:15 p.m. Boxed Lunches

Level of Presentation:

ENDO/ADV=Advanced Endocrine

ENDO/BAS=Basic Endocrine

DM/ADV=Advanced Diabetes

DM/BAS=Basic Diabetes

PHARM/ADV=Advanced Pharmacology

ALL/BAS=All are invited

CONFERENCE PROGRAM SCHEDULE

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2016 NATIONAL CONFERENCE THE SKY’S THE LIMIT: TRANSFORMING OUR FUTURE

Shannon Abernethy, RN, CPN Nurse Navigator Bon Secours Pediatric Endocrinology Richmond, VA

Jennifer M. Barker, MD Associate Professor of Pediatrics University of Colorado Aurora, CO

Cecily Betz, PhD, RN, FAAN Professor of Nursing of Clinical Pediatrics Editor-in-Chief, Journal of Pediatric Nursing: Nursing Care of Children and Families University of Southern California, Keck School of Medicine, Department of Pediatrics Los Angeles, CA

Sarah J. Bottomley, MSN, RN, CPNP Pediatric Nurse Practitioner U.T. MD Anderson Cancer Center Houston, TX

Mandi Cafasso, DNP, RN, CNP Nurse Practitioner Cincinnati Children’s Hospital Medical Center Cincinnati, OH

Kathryn Clark, PPPCNP-BC Pediatric Nurse Practitioner University of Michigan Pediatric Endocrinology Ann Arbor, MI

Sharron Close, PhD, MS, RN, CPNP-PC Clinical Instructor Columbia University School of Nursing Chappaqua, NY

Amelia DeRosa, BSN, RN, CPON Pediatric Long Term Follow Up Program Memorial Sloan Kettering Cancer Center New York, NY

Deborah Diotallevi, MS, RN, CPNP, PMHS Pediatric Nurse Practitioner - Pediatric Long Term Follow Up Program Memorial Sloan Kettering Cancer Center New York, NY

Shayne Dougherty, MSN, CRNP Endocrine Nurse Practitioner/Diabetes Specialist The Children’s Hospital of Philadelphia Doylestown, PA

Andrew Dwyer, PhD, FNP-BC Chef de Projet University Hospital Lausanne Switzerland (CHUV) Lausanne, Switzerland

Vivian Enyo Dzata Pediatric Enodcrine Nurse Practitioner Children’s Hospital of Philadelphia Philadelphia, PA

Jan M. Foote, DNP, ARNP, CPNP Pediatric Nurse Practitioner Blank Children’s Endocrinology Clinic Des Moines, IA

Gregory P. Forlenza, MD, MCR Assistant Professor Barbara Davis Center - University of Colorado Denver Aurora, CO

Joanne M. Goodall, CRNP Nurse Practitioner Center for Adolescent and Young Adult Health - CHP Pittsburgh, PA

Dana Greer, APRN, CPNP, CDE Pediatric Nurse Practitioner, Certified Diabetes Educator Oklahoma University (OU) Physicians-Tulsa Harold Hamm Diabetes & Endocrinology Clinic Tulsa, OK

Carol Howe, PhD, RN, CDE Assistant Professor Harris College of Nursing and Health Sciences Texas Christian University Fort Worth, TX

Tom Karlya, BA Vice President; Author/Creator of www.DiabetesDad.org Diabetes Research Institute Foundation Hollywood, FL

Meg Keil, PhD, CRNP Senior Nurse Practitioner-Research National Institute of Health Chevy Chase, MD

Megan Lessig, MSN, CRNP Pediatric Endocrine Nurse Practitioner The Children’s Hospital of Philadelphia Cherry Hill, NJ

Shari Liesch, BSN, APNP, CDE Nurse Practitioner/Certified Diabetes Educator Children’s Hospital of Wisconsin Neenah, WI

Terri Lipman, PhD, CRNP, FAAN Assistant Dean for Community Engagement, Miriam Stirl Endowed Term Professor of Nutrition, Professor of Nursing for Children University of Pennsylvania School of Nursing - Children’s Hospital of Philadelphia Merion, PA

Aristides K. Maniatis, MD, FAAP Pediatric Endocrinologist Rocky Mountain Pediatric Endocrinology Centennial, CO

Erika McCann, RN, BS, BSN, MS Registered Nurse UPMC Children’s Hospital of Pittsburgh Pittsburgh, PA

Janet L. Moore, MSN, RN, CPNP Pediatric Nurse Practitioner, Instructor of Pediatrics University of Toledo Sylvania, OH

Joanne T. Moser, MSN, CRNP Registered Nurse UPMC Children’s Hospital of Pittsburgh Pittsburgh, PA

Elaine Pottenger, MS, RN, CPNP, PMHS Nurse Practitioner Memorial Sloan Kettering Cancer Center New York, NY

Eileen Pyra, RN,MN Endocrine Clinical Nurse Specialist Alberta Children’s Hospital Calgary, AB, Canada

Melissa Andrews Rearson, MSN/CRNP Pediatric Nurse Practitioner Children’s Hospital of Philadelphia/Division of Endocrinology & Diabetes Philadephia, PA

Mako E. Sather, RN, MSN, CPNP Nurse Practitioner Rocky Mountain Pediatric Endocrinology Littleton, CO

Wendy Schwarz, RN Clinical Resource Nurse Alberta Children’s Hospital Calgary, AB, Canada

Scott Scolnick, M.Ed. Consultant - Bionic Pancreas Program Boston University Boston, MA

Mark A. Sperling, MD Emeritus Professor of Pediatrics, University of Pittsburgh Professorial Lecturer, Dept. of Pediatrics, Icahn School of Medicine at Mt Sinai New York, NY

Linda Steinkrauss, RN, MSN, CPNP Nurse Practitioner A.I.duPont Hospital for Children Newark, DE

Paul Thornton, MD Medical Director Diabetes and Endocrinology Cook Children’s Medical Center Ft. Worth, TX

Donna White, RN, PhD, CS, CADAC Addiction Specialist Lemuel Shattock Hospital Boston, MA

Angela R. Yarbrough, MSN, RN, FNP-BC Family Nurse Practitioner M.D. Anderson Cancer Center Houston, TX

FACULTY LISTING

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SPECIAL NEEDS

I will need assistance: __________________________________________________

I have the following dietary requirements: Gluten Free Diet Vegetarian

Vegan Gluten Allergy Other:____________________________

EMERGENCY CONTACT INFORMATION

Name

Relationship Phone Number

This is my first PENS conference. Do not provide my contact information on vendor lists or pre-registration attendee roster.

STEP TWO: RegistrationA. Pre-Conference Registration - H.A.N.D.S.SM WorkshopPre-Conference Workshop registrations do not include the Thursday New Member, Reception, Welcome Reception or Evening Event. If you would like to attend these events please register below. Member (NASN or PENS) $95 Non-member $115

Section A Total: __________B. Full Conference Registration On or Between After 4/27 before 3/22 3/22 & 4/27 (on-site)

Member $475 $550 $700 Non-Member $600 $675 $825

Section B Total: __________

C. Single Day RegistrationCheck desired day: Thursday Events Only Member $200 Non-Member $325New Member Reception, Welcome Reception and Evening Event only – does not include the Pre-Conference WorkshopFriday Member $225 Non-Member $350Saturday Member $225 Non-Member $350Sunday Member $100 Non-Member $225

Section C Total: __________

PENS Executive Office, P.O. Box 14516, Lenexa, KS 66285-4516 Fax 913-895-4652 Register Online: www.pens.org

Final registration deadline is April 27, 2016. If you are registering after April 8, please bring your completed paperwork and payment with you to the conference.

STEP ONE: Registration Information

First Name M.I. Last Name Credentials (LIST 2 ONLY)

Employer

 Home  Work

Preferred Address – please indicate home or work

City State Zip Country

Daytime Telephone Number Fax

Email Address

E. RSVP!Please indicate which concurrent sessions you are interested in attending. Your assistance will help us assign each speaker to an appropriately sized room. Please check one session letter for each column.

Session 1 Session 2 Session 3 Session 4 Session 5 Session 6 Session 7 A A A A A A A B B B B B B B C C C C C C D D

2016 NATIONAL CONFERENCE REGISTRATION FORM

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Cancellations & TransfersCancellations and transfers must be requested in writing and postmarked, faxed or emailed by April 27, 2016. Refunds will be issued following the conference. A $50 administrative fee will be assessed. Cancellation requests must include the reason for the cancellation. If you transfer your registration to another person, please include a completed registration form for that person with your written request. Requests for cancellation postmarked, emailed or faxed after April 8 are not refundable.

If you register after April 27, please bring your registration form and payment with you to the conference as it WILL NOT be processed at the PENS Executive Office after that date.

D. Spouse/Guest Registration (only includes evening events of Thursday, Friday, and Saturday)

_____ Spouse/Guest $325 total for all three events. $150 each for Thursday, Friday, or Saturday.My Guest will be attending the evening event on: Thursday Friday SaturdayGuest Name(s):

Section D Total: __________

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STEP THREE: Total Fees Enclosed

A. Pre-Conference Registration $____________

B. Full Conference Registration $____________

C. Single Day Registration $____________

D. Spouse/Guest Registration $____________

TOTAL ENCLOSED: $____________

All fees must be paid in U.S. dollars, with checks drawn in U.S. funds on U.S. banks. Purchase orders are NOT accepted.

Check (made payable to PENS) PENS Tax ID: 38-2757646Register online at www.pens.org.

American Express MasterCard Visa Discover

Card Number

Expiration Date

Cardholder Name

Cardholder Signature

Final registration deadline is April 27, 2016Please return this form with the TOTAL AMOUNT DUE to:

Register online at: www.pens.org

By Mail: By Overnight Courier ONLY: By Fax (with credit card information):PENS PENS 913-895-4652P.O. Box 14516 18000 W. 105th St. Lenexa, KS 66285-4516 Olathe, KS 66061

Contact the PENS Executive Office for further information: 913-895-4628.