Registration

June 20-21, 2014

Promoting Professional Accountability: Addressing Behaviors that Undermine a Culture of Safety, Reliability, and Accountability

NOTE: This Registration Form is for participants who are not associated with Vanderbilt or CPPA, or are not from institutions using PARS. Use the Online Registration sidebar link or your browser back button to see alternative registration forms. Questions? Contact us.

Registration fee is $900 per participant. Registration fee includes attendance at all sessions, the course syllabus, CME credit, CNE credit and all food functions. Attire for all sessions: business casual. Your registration confirmation will be sent by e-mail. Please provide the requested information.

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If your mailing address is a non-US address, please check this box before filling in your address information below.

Payment

Registration and payment must be received by June 13, 2014. Checks may be made payable to the Center for Patient and Professional Advocacy (CPPA).

To pay by credit card: download this credit card payment form and return the completed form to CPPA.

Please submit payment to:

The Center for Patient and Professional Advocacy, Vanderbilt University Medical Center
ATTN: Professional Accountability Course
2135 Blakemore Avenue
Nashville, TN 37212-3505
Phone: 615.343.4500 • Fax: 615.343.8580