Diabetic Eye Disease

Educator Program

March 14, 2013

Radisson Paper Valley

Pippin Room

333 W. College Avenue Appleton, WI 54912

Deadline to Register: March 4, 2013

Program limited to the first 30 registrants

General Information

Schedule of Activities

4:00 pm Registration and Boxed Dinner Served

4:00 pm-6:00 pm Diabetic Eye Disease Educator Program Course

Introduction:

Upon successful completion of this course and the post-test participants will be able to provide sound information and strategies to their diabetic clients and patients on maintaining healthy vision. This is a knowledge based activity.

Course Objectives Include:

•Describe basic information on diabetes and diabetic eye disease

•List parts of the eye and be able to articulate how the visual system works

•Explain diabetic retinopathy and be able to list patient education messages about the condition

Faculty:

Erica Kane, BS, CHES, Prevent Blindness Wisconsin – Program Manager

Dale R. Buettner, O.D., Wisconsin Vision

Dennis P. Han, M.D., Professor of Ophthalmology – Froedtert & the Medical College of Wisconsin

Target Audience:

This course is intended for Certified Diabetic Educators, Registered Nurses, and Health Educators

Continuing Education Credit Information:

This continuing nursing education activity was approved by the American Association of Diabetes Educators, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. This program, 2012-051 approved for 2.0 contact hours.

Sponsored By:

This activity is sponsored by the Wisconsin Lions Foundation and the Wisconsin Diabetes Prevention and Control Program.

Cost:

$45.00

Reduced registration fees are available for low-income or unemployed individuals. Please contact Erica Kane, Prevent Blindness Wisconsin Program Manager at (414) 765-0505 or by email to for more information.

Further Information:

Requests for further information should be directed to Erica Kane, Prevent Blindness Wisconsin Program Manager at (414) 765-0505 or by email to

Approval of this educational offering by AADE does not imply endorsement of any specific therapies, treatments, or products discussed in the presentations.

Registration

The registration fee is $45.00 for participants. You will receive confirmation within two weeks of registering.

3 Simple ways to Register:

By Mail:

Return a completed registration form and payment to:

Prevent Blindness Wisconsin

759 N. Milwaukee Street

Suite 305

Milwaukee, WI 53202

By Phone:

Call (414) 765-0505 and pay by MasterCard or VISA.

By Fax:

Complete registration form and fax to (414) 765-0377 with your MasterCard or VISA information.

CancellationPolicy:

The course reserves the right to cancel due to insufficient registration. In case of cancellation for this reason or for inclement weather, registration fees will be refunded in full. For cancellations received by February 28, 2013 the registration less a $25.00 administrative fee will be given. No refunds will be made after this date. To cancel, call (414) 765-0505.

Registration Form

Yes, register me for Prevent Blindness Wisconsin’s Diabetic Eye Disease Educator Program on March 14, 2013.

First Name (Please Print) / Last Name (Please Print)
RN License Number / AADE Member Number
Organization Name
Mailing Address
City / State / Zip Code

Phone (Work) Phone (Home)

Fax Email Address (Required)

The registration fee is $45.00 for participants. You will receive confirmation within 2 weeks of registering.

Payment Options

Check

Check Enclosed

Amount Enclosed: ______

Credit Card

Please Charge My:

MasterCard Card #: ______

 VISA

EXP: ______CV#: ______

Signature: ______

Return completed registration form to: For office use only

Paid in full

Prevent Blindness Wisconsin

759 N. Milwaukee Street

Suite 305

Milwaukee, WI 53202

Phone: (414) 765-0505

Fax: (414) 765-0377