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QCC  Registration Form

City of the Seminar you wish to attend:

     TORONTO - 2011

                                    Name:

 

  Please print name as you want it to appear on your certificate

Facility or Hospital name:

 

Facility Street:

 

Facility City:

 

Facility State:

 

Facility Zip:

 

Facility Phone and Ext:

 

Facility Fax:

 

Home Address:

 

Home City:

 

Home State:

 

Home Zip:

 

Home Phone:

 

Email Address:

 

Credit Card Type:

Master Card Visa 

Credit Card Number:

 

Expiration Date:

 

Please sign:

 

Please complete form and return

by email attachment to: mom4apc@gmail.com 

or mail with check for $319.00 US made out to:

Louise Miller RTRM
P.O. Box 362
Pine Valley, CA 91962  

or fax to:  (619) 473-8610

ONE FORM PER PERSON PLEASE 

pLEA

 

QCC 2011 TORONTO

 

APRIL 9-10, 2011

 

Sponsored by:

 

Agfa Healthcare

Christie InnoMed*

 

Holiday Inn Toronto International Airport

970 Dixon Road - Toronto, ONT

$99/night + tax 

 

Hotel:  416-675-7611   Reservations:  877-865-6578

 

Be sure to mention QCC Seminars when making your reservation

In order to secure space at this rate please make reservations by 3/30/11

 

**!! SPECIAL EVENING RECEPTION !!

SPONSORED BY CHRISTIE INNOMED ON SAT EVENING FOLLOWING THE CONFERENCE

 

CURRICULUM

  

Today’s Mammographer:  Professional, Resilent and Compassionate

Positioning:  Anything new…or same old thing?

From Roentgen to Starwoods:  Breast Imaging, Past, Present and Future

Why Me?:  Dealing With the Impossible Patient

Quality Control:  Creating Excellence in a Digital World

Mentoring Mammography:  The Future Is In Your Hands!

Positioning Demo

Dilemmas in Diagnosis:  What Do I Do Now?

Clinical Findings:  What You Need To Know

All Hail!!  The Queen of Mammoland!

New Kids on the Block:  BSGI, Whole breast US and more

After the Diagnosis:  Reconstruction Options

 

 

15 Continuing Education Credits – to be approved by ASRT

 

Cost:  $319.00 US FUNDS ONLY

 

IN AN EFFORT TO “GO GREEN

PLEASE HELP US KEEP FROM USING PAPER NEEDLESSLY BY

USING ONE OF THE FOLLOWING REGISTRATION OPTIONS:

 

REGISTER ONLINE AT WWW.MAMMOTECH.COM (available after 2/26)

or

 SEND COMPLETED FORM BY EMAIL ATTACHMENT TO: 

mom4apc@aol.com

or

COMPLETE ATTACHED FORM AND FAX TO (619) 473-8610

or

SUBMIT FORM(S) BY ANY METHOD ABOVE AND THEN MAIL CHECK(S) AS INSTRUCTED ON FORM 

 

 **BE SURE TO INCLUDE ATTENDEES’ NAMES WHEN SENDING CHECK(S)**

 

 

Checks payable to:  Louise Miller, RTRM……NOT QCC

 

QCC CONTACT INFO: 

 

Erin  (619) 993-1204 or mom4apc@gmail.com

Louise (619) 787-2293 or lcmrtrm@aol.com

FAX:  (619) 473-8610