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CORPORATE SPONSORS Special thanks to our 2020 Corporate Sponsors for their outstanding support of The Podiatry Institute and the continued development of excellence in post-graduate continuing educa tion. Please support these companies that support your profession. PLATINUM Bako Diagnostics CuraMedix Horizon Therapeutics PICA Quantum Pathology Televere Systems GOLD Amerx Health Care Arthrosurface CrossRoads Extremity Systems Ortho Dermatologics SILVER Delta Surgical Instruments Marlinz Pharma BRONZE Podiatry Content Connection Redi-Thotics Sammy Systems The Tetra Corporation Photo courtesy of ©Hilton Head Island V&CB The Podiatry Institute cannot be held liable for events beyond its control, such as acts of God, government regulations, disasters or weather-related hazards, civil unrest, or any other emergency, making it inadvisable or impossible to hold the conference. The Podiatry Institute will make every effort to inform the participants as soon as possible to enable the participants to cancel hotel and flight arrangements. The entire contents of this brochure are copyrighted by The Podiatry Institute with all rights reserved. Reproduction or use, without permission, of written or graphic content in any manner is prohibited. ©2020 HILTON HEAD NEWPORT April 30 - May 3 Surgical Pearls by the Sea with Rhode Island Podiatric Medical Association HILTON HEAD June 18-21 Footprints in the Sand with South Carolina Podiatric Medical Association PHILADELPHIA September 11-13 Insights & Advancements with Penn Presbyterian Medical Center SAN DIEGO September 24-27 UPDATE 2020 with San Diego Podiatric Medical Society MID-ATLANTIC October 16-18 Mid-Atlantic Conference with Mid-Atlantic Podiatric Medical Association ATLANTA October 22-25 UPDATE 2020 Reconstructive Surgery of the Foot & Ankle SANIBEL November 5-8 Hallux Valgus & Related Forefoot 30th Annual Sanibel Conference CHICAGO December 4-6 Windy City Conference with Illinois Podiatric Medical Association ABOUT YOUR HOSTS UPCOMING CONFERENCES The Podiatry Institute is a non-profit educational foundation that offers a variety of programs, conferences, workshops and postgraduate courses. The Institute has achieved international recognition for its leading role in developing and advancing podiatric medicine and surgery. The faculty members are all volunteers who serve without compensation. They are committed to ongoing education in the area of foot and ankle surgery. South Carolina Podiatric Medical Association’s mission includes promoting and pursuing excellence in all aspects of podiatric medicine; seeking conditions and environments which support optimal practice and patient care; keeping its Members informed about any and all changes in regulations, legislation and other areas that may affect the podiatric medical practice; and more. Please visit www.scpma.us for more information.
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The Podiatry Institute - Seminars, Surgery Courses, …podiatric medicine and surgery. The faculty members are all volunteers who serve without compensation. They are committed to

Jul 26, 2020

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Page 1: The Podiatry Institute - Seminars, Surgery Courses, …podiatric medicine and surgery. The faculty members are all volunteers who serve without compensation. They are committed to

Corporate SponSorS Special thanks to our 2020 Corporate Sponsors for their out standing support of The Podiatry Institute and the continued devel opment of excellence in post-graduate continu ing educa tion. Please support these companies that support your profession.

PLATINUMBako Diagnostics

CuraMedix

Horizon Therapeutics

PICA

Quantum Pathology

Televere Systems

GOLDAmerx Health Care

Arthrosurface

CrossRoads Extremity Systems

Ortho Dermatologics

SILVERDelta Surgical Instruments

Marlinz Pharma

BRONZEPodiatry Content Connection

Redi-Thotics

Sammy Systems

The Tetra Corporation

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The Podiatry Institute cannot be held liable for events beyond its control, such as acts of God, government regulations, disasters or weather-related hazards, civil unrest, or any other emergency, making it inad visable or impossible to hold the conference. The Podiatry Institute will make every effort to inform the participants as soon as possible to enable the participants to cancel hotel and flight arrange ments. The entire contents of this brochure are copy righted by The Podiatry Institute with all rights reserved. Repro duction or use, without permission, of written or graphic content in any manner is prohibited. ©2020

Hilton Head

NEWPORT April 30 - May 3Surgical Pearls by the Seawith Rhode Island Podiatric Medical Association

HILTON HEAD June 18-21Footprints in the Sandwith South Carolina Podiatric Medical Association

PHILADELPHIA September 11-13Insights & Advancementswith Penn Presbyterian Medical Center

SAN DIEGO September 24-27UPDATE 2020with San Diego Podiatric Medical Society

MID-ATLANTIC October 16-18Mid-Atlantic Conferencewith Mid-Atlantic Podiatric Medical Association

ATLANTA October 22-25UPDATE 2020Reconstructive Surgery of the Foot & Ankle

SANIBEL November 5-8Hallux Valgus & Related Forefoot30th Annual Sanibel Conference

CHICAGO December 4-6Windy City Conferencewith Illinois Podiatric Medical Association

about Your HoStS

upComing ConferenCeS

The Podiatry Institute is a non-profit educational foundation that offers a variety of programs, conferences, workshops and postgraduate courses. The Institute has achieved international recognition for its leading role in developing and advancing podiatric medicine and surgery. The faculty members are all volunteers who serve without compensation. They are committed to ongoing education in the area of foot and ankle surgery.

South Carolina Podiatric Medical Association’s mission includes promoting and pursuing excellence in all aspects of podiatric medicine; seeking conditions and environments which support optimal practice and patient care; keeping its Members informed about any and all changes in regulations, legislation and other areas that may affect the podiatric medical practice; and more. Please visit www.scpma.us for more information.

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HILTON HEAD MARRIOTT RESORT & SPAHILTON HEAD ISLAND, SOUTH CAROLINA

THE PODIATRy INSTITUTE JOINT PROVIDER WITH

SOUTH CAROLINA PODIATRIC MEDICAL ASSOCIATIONPRESENTS

FOOTPRINTS IN THE SAND 2020CHALLENGING CASES & CURRENT TREATMENTOPTIONS IN PODIATRIC MEDICINE & SURGERy

This is a PICA approved risk management seminar.

®

THE PODIATRy I N S T I T U T E

2675 North Decatur RoadSuite 309Decatur, GA 30033-6132

A NONPROFIT TEACHING FOUNDATION

June 18-21

NonprofitOrganizationU.S. Postage

PA I DAtlanta, GA

Permit #1954

Hilton HeadAssistants’ Program June 18-20

Radiology Review • ASPMA Radiology Certifi cation Exam • Workshops

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HIGHLIGHTSShelter Cove Harbour is a laid-back Mediterranean-style village that combines the Island’s best shops, restaurants and waterfront activities in one location. 843.548.0532 www.sheltercovehiltonhead.com

Harbour Town, surrounding Sea Pines’ picturesque yacht basin, features a collection of boutiques, stores and galleries. For a stunning aerial view, climb the winding steps to the top of the beloved candy-stripe lighthouse! Kids of all ages won’t want to miss nightly performances by the legendary entertainer Gregg Russell. 843.785.3333 www.seapines.com

Coastal Discovery Museum Indoor and outdoor exhibits, tours and cruises give you hands-on exploring of the history, wildlife, and heritage of Coastal Carolina. 843.689.6767 www.coastaldiscovery.org

NATURE LOVERSHilton Head Island Audubon Society Beaches, marshes, lagoons, bike trails and harbours throughout the island are areas for birding. www.hiltonheadaudubon.org

Pinckney Island National Wildlife Refuge See a wide variety of wildlife. Walk around the island on the 14 miles of trails, bike or kayak. 843.784.2468 www.fws.gov/pinckneyisland

Sea Pines Forest Preserve See the Warner W. Plahs Wildflower Field, visit the 4,000-year-old Indian Shell Ring, and enjoy a scenic ride down the rice dike. 843.671.1343 www.sea pinesliving.com/explore-sea-pines/attractions/forest-preserve/

ADVENTURESHilton Head Scavenger Hunt Lace up your walking shoes and put your navigation skills to the test. Fun for all ages! 833.202.7626 letsroam.com

ZipLine Hilton Head offers a canopy tour 75’ in the air, swaying bridges and an aerial staircase. 843.682.6000 www.ziplinehiltonhead.com

FAMILy FUNAdventure Cove For all ages with miniature golf on two Caribbean style courses and the island’s only arcade. 843.842.9990 www.adventurecove.com

Pirate’s Island Adventure Golf Swashbuckling adventures on miniature golf courses with a dungeon and a pirates’ treasure. 843.686.4001 piratesislandgolf.com

The Salty Dog Cafe The famous outdoor cafe inspired by Jake the Salty Dog and his heroic feat! Ocean breezes, tropical freezes, and entertainment for all ages. 843.671.2233 www.saltydog.com

The Sandbox, An Interactive Children’s Museum Children can sail away on Captain William Hilton’s ship of discovery or find a plane ready for little pilots to fly. 843.842.7645 www.thesandbox.org

Hilton Head to do & See

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HILTON HEAD MARRIOTT RESORT & SPAOne Hotel Circle, Hilton Head Island, SC 29928 888.511.5086 or 843.686.8400 (mention The Podiatry Institute for special rate)

Discover your personal oasis at the Hilton Head Marriott Resort & Spa. Escape from the ordinary and enjoy spacious guest rooms, award-winning dining, three outstanding golf courses, a fitness center, indoor and outdoor pools, and the lavish Spa Soleil. The Hilton Head Marriott’s location offers easy access to local airports, shopping and popular tourist attractions.

Rate: $224- $294 (plus tax, subject to change without notice) *Register online via the Hilton Head page at www.podiatryinstitute.com.

A block of rooms has been reserved and will be held until it is full or May 13, 2020, whichever comes first. Please book early to guarantee your reservation. In order to secure our special group rate, advanced reservations are mandatory and you must advise Reservations that you are attending The Podiatry Institute conference. Rates cannot be changed for guests who fail to identify their affiliation at the time the reservation is made. Rate applicable 3 days before/3 days after (based on availability).

TRAVEL DISCOUNTSTo obtain the best possible rates and make your reservations, please call our official agency:

Travel Leaders 678.689.0176 (A $35.00 SeRvice fee will APPLy FOR THE FIRST PASSENGER; $15.00 FOR EACH AddiTionAl PASSengeR.)

If you have trouble securing hotel accommodations, please call Trish at Travel Leaders.

Visit www.hiltonheadisland.org for more information on attractions and activities!

Footprints in the Sand for AssistantsPresented by American Society of Podiatric Medical Assistants In Partnership with The Podiatry Institute and SCPMA

Thursday, June 18 1:30-7:30 – Radiology Review Course (6 Hours)

Friday, June 19 1:30-3:00 – ASPMA Radiology Certification Exam

Saturday, June 20 (4 Hours of Workshops) 1:30-3:30 – Workshop: Hands-on shoe fitting instruction, measuring,

casting and molding taught by certified pedorthists3:30-4:00 – BREAK4:00-6:00 – Workshop: HIPAA compliance training, DME

documentation and office management pearls, etc.Both workshops have been certified and accredited through CAPMAC for a total of 4 CEU’s.

Member: ❑ $125 Registration ❑ $325 Radiology Exam RegistrationNon-member: ❑ $150 Registration ❑ $600 Radiology Exam Registration

TOTAL $_ _ _ _______ REFUND POLICy: $25 Non-refundable Administration Fee

PLEASE PRINT CLEARLy

Name ___________________________________________________

PMAC ___________________________________________________

Practice Name ____________________________________________

Address __________________________________________________

City/State/Zip _____________________________________________

Office Phone _____________________________________________

Cell Phone _______________________________________________

Fax ______________________________________________________

Email ____________________________________________________

My check, payable to The Podiatry Institute (EIN #58-1906272), is enclosed ❑ or charge my ❑ Visa ❑ M/C ❑ AmEx ❑ Disc

Credit Card No. ____________________________Exp.Date ___ / ___

Cardholder Name _________________________________________

Signature ________________________________________________

Mail to: The Podiatry Institute 2675 North Decatur Rd. Suite 309 Decatur, GA 30033

❑ yes ❑ No

NOTE: You must pay Registration fee AND Exam fee to take Radiology exam!

Photo courtesy of ©H

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n Lighthouse at The Sea Pines Resort)

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ConferenCe obJeCtiVeSAt the conclusion of the conference, the participant should be able to:

Trauma: The attendee will gain the basic knowledge to recognize, evaluate, diagnose and manage common disorders seen in trauma to the foot and ankle and the long term sequalae in different groups.

forefoot: The attendee will be exposed to the various options in the repair of hammertoes and to address the options, risks and long term complications of different procedures on the 2nd MPJ.

Hallux valgus: The attendee will become familiar with all different surgical procedures in the management of hallux valgus and associated deformities and their roles.

Diabetic Foot: The attendee will become familiar with the current treatment options and advanced therapies in treating the diabetic foot.

Heel and Hindfoot: The attendee will discuss the goals and expected outcomes in the rearfoot. This includes soft tissue management, fractures, heel surgery and management of failed tendon surgeries.

Medicine & Topics of Interest: The attendee will gain knowledge and understanding of different products and their cost, diagnosis of carcinoma, understanding of the mechanism of ankle fractures and some less common anatomical variants and procedures.

fridaY JUNE 19 7:00 AM BREAKfAST LECTuRE

A Biologic Approach to Treat uncontrolled Gout with Tophi with Matt Garoufalis, DPMsponsored by Horizon therapeuticsNote: This is a non-CME presentation.

7:30 AM HALLUX VALGUS RECONSTRUCTION

Juvenile HAV

Current Applications of the Base Wedge Osteotomy for HAV

The Evolution of the Lapidus

HAV: A New Old Approach

Bunion Surgery: What I’ve Learned in the Past 35 years

Question & Answer

9:30 AM REfRESHMENT BREAK — vISIT EXHIBIToRS

10:00 AM RISK MANAGEMENT SESSIONCurrent Guidelines for Narcotic Prescribing for Podiatrists in 2020Note: There will be a separate sign-in for this lecture.

11:00 AM HALLUX LIMITUSArthrofi brosis of the 1st MTPJ following HAv Surgery

Hallux Rigidus

1st MTPJ Arthrodesis vs. Joint Replacement

1st MTPJ Arthrodesis: Focus on Fixation

1st MTPJ Arthrodesis: Functional Outcomes A Current Literature Review

Treating diffi cult Podiatric conditions with MlS laser Therapy

Question & Answer

1:00 PM fRIDAY SESSIoN ADJouRNS

tHurSdaY JUNE 18

7:00 AM BREAKfAST WITH EXHIBIToRS

7:25 AM WELCoME SCPMA PRESIDENT, JAMELAH LEMoN

7:30 AM REARFOOT PATHOLOGyA New Theory of Plantar Heel Pain Syndrome

PCDO with Tendon Transfer in Adult Flatfoot

Evans Calcaneal Osteotomy: Surgical Technique and Pearls

Achilles and Gastrocnemius Equinus

Current Concepts in Arthroereisis

I Learned the Triple, But is a Double Enough?

Please Stop Cutting the Plantar Fascia

Diagnosis and Treatment of Common Nail, Skin, Nerve Pathology

Question & Answer

10:30 AM REfRESHMENT BREAK — vISIT EXHIBIToRS

11:00 AM WORKSHOPSNoTE: You MuST ATTEND oNE WoRKSHoP PER RoTATIoN To RECEIvE fuLL CME CREDITS. THERE WILL BE A SIGN-IN SHEET IN EACH WoRKSHoP PER RoTATIoN.

Hands-on workshops featuring latest techniques & technologies

Podiatric Dermatology: Advanced Hands-on Biopsy and Skin flap Workshop, with Tracey C. Vlahovic, DPM

Improve Your outcomes with orthotics and Bracing, with Douglas H. Richie, DPM

Practicing Evidence-Based Medicine with Shock Waves

Regaining Motion after failed Hallux Rigidus Surgery

1:00 PM THuRSDAY SESSIoN ADJouRNS

SOUTH CAROLINA PODIATRIC MEDICAL ASSOCIATION

NEW

COURsE!

ANNUAL GOLF TOURNAMENT

fRIDAY, JuNE 19

Port Royal Golf Club-Barony Course10 Clubhouse Dr, Hilton Head Island, SC 29928

12:00 �� Registration & Check-in Begins1:30 �� Shotgun Start - Captain’s Choice

REGISTRATION COST*: SCPMA Members: $100.00 per player

Non-Members: $125.00 per player *Includes lunch, range balls, cart & green fees. Individual Registrants will be placed on teams.

***SPoTS ARE LIMITED To 48 PLAYERS So You MuST REGISTER To PLAY BY JuNE 1ST***

Please visit the Hilton Head conference page at www.podiatryinstitute.com to download registration form.

(50% of profit made will go to the sCPMA PACfund in accordance with state Ethics laws.)

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TENTATivE PROgRAM, sUBJECT TO CHANgE WiTHOUT NOTiCE

SaturdaY JUNE 20

7:00 AM BREAKfAST WITH EXHIBIToRS

7:30 AM HIGH RISK DILEMMAS: DIABETES, CHARCOT,

WOUNDS, INFECTIONManaging the Infected Foot: What Does the Literature Say?

Sepsis Update

Injectable Calcium Sulfate with Antibiotics in Osteomyelitis

Amniotic Grafts and Injectables in Wound Healing

Surgical Wounds Following Elective Cases

HIPJ DJD in Neuropathic Patients After 1st MTPJ Arthrodesis

Beaming Techniques for Charcot

Question & Answer

10:00 AM REfRESHMENT BREAK — vISIT EXHIBIToRS

10:30 AM TOPICS OF INTERESTNeoplasms

Surgical Excision of Soft Tissue Tumors

cRPS: what to look for in a Busy offi ce

DVT Prophylaxis: Current Recommendations

Question & Answer

12:00 PM COMPLICATIONS IN FOOT & ANKLE SURGERy

Case Presentations; ACFAS Mid-Atlantic Region

1:00 PM SATuRDAY SESSIoN ADJouRNS

up to 20 CeCHsThis activity has been planned and implemented in accordance with the standards and requirements for approval of providers of continuing education in podiatric medicine through a joint provider agreement between The Podiatry Institute and South Carolina Podiatric Medical Association. The Podiatry Institute is approved by the Council on Podiatric Medical Education as a provider of continuing education in podiatric medicine. The Podiatry Institute has approved this activity for a maximum of 20 continuing education contact hours.

SundaY JUNE 21 7:00 AM BREAKfAST

7:30 AM FOREFOOT & MIDFOOT PATHOLOGy

The Transitional Weil: An Update

Brachymetatarsia

Forefoot Reconstruction in the Rheumatoid Foot

Lengthening 1st Metatarsal Osteotomy for 2nd MPJ Capsulitis

Midfoot Arthrodesis with Trephine Technique

9:10 AM CHALLENGING MEDICINE & SURGERy

non-unions: Simplifi ed Treatment Approach

Hemostatic Agents in Podiatry

Peri-Operative Management of Anti-Coagulants

Interpositional Arthroplasty with Human Dermal Collagen Matrix of Non-Essential But Useful Joints on the Foot

WALANT: Can It be Done in the Foot?

10:30 AM REfRESHMENT BREAK

10:45 AM TRAUMA & ANKLE RECONSTRUCTION

Repair of Advanced Achilles Degeneration

Lesser Metatarsal Fractures

Sesamoid Injuries: When to Take It Out?

Ankle Destruction/Reconstruction

Lateral Ankle Instability: The Internal Brace

Talar Neck Fractures

Lis Franc’s Injury and Repair

1:00 PM CoNfERENCE ADJouRNS

diStinguiSHed faCultY

Each speaker is required to disclose the exis tence of any financial and/or other rela tionship(s) (e.g., employee, con sul tant, speaker’s bureau, grant recipient, research support) he/she might have with a) the manu facturer(s) of any com mer cial product(s) to be dis cussed during his/her pre sen ta tion and/or b) the commercial contributor(s) of the activity.

SCIENTIFIC CHAIRMAN

Michelle L. Butterworth, DPM kingstree, sc

SPECIAL GUESTS

Patrick DeHeer, DPM franklin, IN

Matthew G. Garoufalis, DPM chicago, Il

Steve A. McClain, MD smithtown, Ny

Roland Ramdass, DPM Winchester, Va

Douglas H. Richie, DPM associate clinical Professor, Department of applied Biomechanics, california school of Podiatric medicine at samuel merritt college, seal Beach, ca

Tracey C. vlahovic, DPM Professor, temple university school of Podiatric medicine, Philadelphia, Pa

THE PoDIATRY INSTITuTE

Alan S. Banks, DPM Private Practice, atlanta, ga

Alan J. Block, DPM columbus, oH

Michael S. Downey, DPM Philadelphia, Pa

John C. Haight, DPM Emory Decatur Hospital, Decatur, ga

William H. Hatchett, DPM Private Practice, summerville, sc

Lauren Kuenzi, DPM Emory Decatur Hospital, Decatur, ga

Joshua J. Mann, DPM Jonesboro, ga

Michael C. McGlamry, DPM Private Practice, cumming, ga

Adam Port, DPM Private Practice, athens, ga

Rahn A. Ravenell, DPM Private Practice, mount Pleasant, sc

Mickey D. Stapp, DPM augusta, ga

Trent K. Statler, DPM Private Practice, Beaufort, sc

Eugene D. Timpano, DPM cinnaminson, NJ

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CANCELLATION requests must be made in writing, via fax or mail, and postmarked no later than one month before the start date of the confer ence. All cancel lation requests will be assessed a $75 admin is tra tive fee. There will be no refunds for cancel lations made less than one month prior to the start of the con ference. Instead a “certificate of transfer” will be issued, redeem able for any Podiatry Institute con ference of equal price or as partial registra tion fee on any higher price confer ence. The certifi cate will be valid for a period of one year from date of issue. NO cancel lations or trans fers will be accepted within two weeks of the start of the conference. In the event the conference is cancelled by events beyond our control, the participant will receive a full refund or transfer to another conference, without penalty, within 30 days of the notice of cancellation.

THE PODIATRy INSTITUTE

®OUR MISSIONTo be a supportive global network of members, colleagues, and friends that enhances the quality of life for patients with foot, ankle, and leg disorders through innovative education, research, and service.

BOARD OF DIRECTORSAlfred J. Phillips, DPMCHAIRMAN

Rahn A. Ravenell, DPMIMMEDIATE PAST CHAIRMAN

Michelle L. Butterworth, DPMVICE-CHAIRMAN

Joshua J. Mann, DPMTREASURER

Bradley D. Castellano, DPMSECRETARy

Eugene D. Timpano, DPM Andrea D. Cass, DPM

Daniel F. Vickers, CAE EXECUTIVE DIRECTOR

SEMINAR COMMITTEEJohn A. Ruch, DPM DIRECTOR OF MEDICAL EDUCATION

Brian B. Carpenter, DPM CORPORATE LIAISON

Michelle L. Butterworth, DPM Michael S. Downey, DPM Annette D. Filiatrault, DPM Todd B. Haddon, DPM Donald R. Green, DPM Clifford D. Mah, DPM D. Scot Malay, DPM Michael C. McGlamry, DPM Alfred J. Phillips, DPM Scott R. Roman, DPM Joe T. Southerland, DPM

The Podiatry Institute is a non-profit educational foundation that offers a variety of programs including conferences, work-shops and post-graduate courses, in addition to textbooks, DVDs, PowerPoint® presentations and patient education materials. The Institute has achieved national and international recognition for its leading role in developing and advancing the standard of care in podiatric medicine and surgery. The faculty members are all volunteers who serve without compensation. They are committed to ongoing education in the area of foot and ankle surgery.

For more information, please visit www.podiatryinstitute.com

MAKE CHECKS PAyABLE TO: The Podiatry Institute OR USE ❏ M/C ❏ VISA ❏ AX ❏ DISC

Card # _____________________________________________________________ Exp. Date ________________________ MM / yy

Signature _______________________________________________________________ Date ________________________

R E G I S T E R f o R A 2020 S E M I N A R AT T H E R E G u L A R R AT E A N D R E C E I v E 25% o f f Yo u R S E C o N D 2020 S E M I N A R

VALID ONLy FOR SEMINARS. DOES NOT APPLy TO RESIDENTS, RETIRED, MILITARy OR APMA yOUNG MEMBERS. DOES NOT APPLy TO EXHIBITOR REGISTRATION OR CADAVER SURGICAL SKILLS COURSES.

CALL BEFORE REGISTERING FOR THE SECOND SEMINAR TO RECEIVE THE DISCOUNT.

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❑ $465 SCPMA Member Only on or before 5/7/20

❑ $565 on or before 5/7/20

❑ $615 on 5/8/20 through 6/4/20

❑ $715 after 6/4/20 or at the door (Credit Card ONLY)

❑ $340 Retired Podiatrists or Active Military

❑ $125* Residents with letter from Residency Director

*DoEs Not aPPly to caDaVEr WorksHoPs. LETTER MUsT BE sUBMiTTED BY MAiL WItH your comPlEtED rEgIstratIoN form. rEsIDENt rEgIstra tIoN Not accepted by e-mail or online.

❑ Special Seminar Rate for APMA Young Members. Call 888.833.5682.

❑ food functions are open to registered attendees only. Additional meal packages can be purchased for family/guests. Includes 4 breakfasts and 4 breaks.

____ # of AdulTS ($100 eAcH)

____ # OF CHILDREN 12 & undeR ($50 eAcH)

$_ _ _ __________________ HILTON HEAD TOTAL

PLEASE PRINT CLEARLy

Name _________________________________________________________________________________________________

Address ________________________________________________________________________________________________

City ____________________________________________ State __________ Zip __________________________________

Phone __________________________________ First Name for Name Tag __________________________________________

Email __________________________________________________________________________________________________ (You MuST PRovide eMAil AddReSS To Receive confiRMATion And cMe ceRTificATe)

___________________________________________________________________________________________________ PLEASE INDICATE ANy SPECIAL NEEDS yOU HAVE AND WE WILL CONTACT yOU

___________________________________________________________________________________________________

if YOU DO NOT RECEivE AN EMAiL CONfiRMA TiON, PLEAsE CALL OUR OffiCE TO CONfiRM REgisTRATiON.

Hilton Head regiStrationCHOOSE ONE OF fouR EASY WAYS TO REGISTER

ONLINE

(BefoRe 6/4/20) www.podiatryinstitute.com

PHONE

888.833.5682 or 770.939.0393

fAX

404.508.8539

MAIL

The Podiatry Institute 2675 N Decatur Rd, Ste 309 Decatur, GA 30033-6132