Pharmacy Australia Congress 2013BRISBANE CONVENTION & EXHIBITION CENTRE

Registration form

pac13

10 –13 October ONE | profession, focus, voice

www.psa.org.au/pac

CPD CREDITS

UP

TO

GROUP 1 & 2

95

PAC13 REGISTRATION FORMPAC 13 is better than ever and one of the main differences with this year’s program is the way CPD will be delivered. PSA has listened to the PAC12 delegate feedback and as a result clinical information will also be taught with a section on how to implement that clinical knowledge into your everyday pharmacy practice. Consumer perspectives relating to pharmacy health topics will also play a central role in the CPD aspect of PAC13.

New and improved!Another key difference of PAC in 2013 is that the Sunday program will be completely dedicated to workshops. Hot topics in pharmacy including cardiovascular disease, everyday minor ailments and male mental health are all standouts in this year’s workshop line-up. Popular workshops will be repeated which means you won’t miss out on the ones you want to attend. Please note that places are strictly limited to 90 delegates per workshop.

Internationally recognised speakers!Confirmed speakers to PAC13 include Professor Zubin Austin, Professor Claire Anderson and Professor Ian Frazer.

Professor Zubin Austin is an award-winning educator and researcher at The University of Toronto. He has received the Government of Ontario’s Leadership in Faculty Teaching award and the Faculty of Pharmacy’s Teacher of the Year award on seven separate occasions. His research in pharmacy education has been widely cited and recognized. Professor Austin’s topic at PAC13 is One interesting profession globally – influence of peer groups on learning and professional practice – why pharmacists are our own worst enemy.

Professor Claire Anderson is the head of the division of Social Research in Medicines and Health within the School of Pharmacy at The University of Nottingham. Professor Anderson’s research seeks to improve

patient and public health in the light of contemporary health care reforms. More recent and developing interests are global health professional education and human resources for health, working in partnership with WHO, UNESCO and the International Pharmaceutical Federation (FIP). Professor Anderson’s topic at PAC13 is One patient: Patients’ experiences of using medicines.

In 1985, Professor Ian Frazer took up a teaching post at the University of Queensland, where he established the Centre for Immunology and Cancer Research. He focussed on the link between Human papillomavirus (HPV) and cervical cancer. By 1991 his team had created a world-first vaccine and began approaching drug companies for investment in development and clinical trials. Fifteen years later the first vaccine was released.

Professor Frazer is president of Cancer Council Australia, and advises the World Health Organisation and the Bill and Melissa Gates Foundation on papillomavirus vaccines. He won the 2005 CSIRO Eureka Prize for Leadership in Science, the Australian of the Year in 2006, and the Prime Minister’s Prize for Science in 2008 and currently teaches at the University of Queensland. Professor Frazer will be delivering the 2013 Alan Russell Oration – The Gardasil Journey.

Social functionsWelcome reception

The welcome reception is a great way to learn what new products are out in the marketplace from our exhibiters. It is also serves as a great platform to network with industry colleagues old and new over a few drinks and nibbles.

The welcome reception is on Friday 11 October at 5:30pm in the exhibition area.

Meet the profession cocktail party

A new event for the PAC13 calendar is the meet the profession cocktail party. This event will bring together pharmacy owners and experienced senior pharmacy industry professionals to meet any delegates looking to increase their professional network or looking to make the next move in their career.

The cocktail party is on Friday 11 October from 7:00pm.

PAC13 Gala Dinner

The highlight of the PAC social events is the annual Gala Dinner. This year the theme is “Beach Party”. Come take a dive on the wild side at the PSA Beach Party and drink and dance the night away – you might even be able to feel the sand between your toes!

The PAC13 Gala Dinner is on Saturday 12 October from 7:00pm in the Brisbane Convention & Exhibition Centre Plaza Ballroom.

PAC13 PROGRAM

Thursday, 10 October 2013

Plenaries Advanced practice Suitable for Accredited Pharmacist

Issues in practice Evidence , practice, patient

Opening Plenary

One profession; One interesting profession globally - Influence of peer groups on learning and professional practice – why pharmacists are our own worst enemy! One Health Care Policy for Australia

Advanced Practice education

Pain Management practice in Pharmacy

Working with Medicare Locals

Mental Health Evidence

Mental Health Practice

Mental Health Consumer

Diabetes Evidence

Diabetes Practice

Diabetes Consumer

2nd Plenary

One career progress – progressing the Advanced Pharmacy Practice Framework; One patient: Patients’ experiences of using medicines; One Industry – how industry supports the practice of pharmacy in delivering to patients

3rd Plenary

PSA Awards Ceremony; Alan Russell Oration: Professor Ian Frazer – the Gardasil journey

Pharmacy Student of the Year Competition

AACP National Conference

Exhibition open

Panel Session

One Health System, One Patient, Many Professionals

Continuing Professional Development Special Sessions Early Career Pharmacists

Respiratory – Clinical Pain – Clinical Medicines, pregnancy, breast feeding and nutrition – Clinical

Contributed papers You and Your career

Respiratory – Implementation

Pain – Implementation Medicines, pregnancy, breast feeding and nutrition – Implementation

Better business Part 1 Gastro-Intestinal – Clinical Drugs in Sport – Clinical The History of Pharmacy – where is our one profession at now?

Negotiating for you – getting a better wage!

Better business Part 2 Gastro Intestinal – Implementation

Drugs in Sport – Implementation

Anti-coagulation therapies – Clinical

Immunisation – Clinical Sexual Health – Clinical Rural Pharmacy Practice – how to be one profession, but different

Anti-coagulation therapies – Implementation

Immunisation – Implementation Sexual Health – Implementation

Gala Dinner – Beach Party theme

Sunday, 13 October 2013

Saturday, 12 October 2013

Friday, 11 October 2013

Male mental health – sad blokes, understanding men and depression

MedsCheck implementation

Smoking cessation services in pharmacy

Clinical Interventions Cardio Vascular Disease, evidence, practice and consumer

Ouch – that hurts. Every day Pharmacy – working with minor ailments

Male mental health – sad blokes, understanding men and depression - Rpt

MedsCheck implementation - Rpt

Wound care management – practical procedures in pharmacy

Clinical Interventions - Rpt Contributed papers 3 Ouch – that hurts. Every day Pharmacy – working with minor ailments - Rpt

Smoking cessation services in pharmacy - Rpt

Pharmacists working in Government

Wound care management – practical procedures in pharmacy - Rpt

Section A: Contact details

Family name: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .First/Given name: ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Title: Prof/Dr/Mr/Ms/Other: ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Position: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Organisation: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Department: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postal address: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City: ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . State: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Postcode: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Country: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone (work): .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Fax: ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mobile: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Email: ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General information

Please note any specific dietary, medical, mobility or other requirements (e.g. wheelchair access or vegetarian meals):

..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name for name badge: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Section B: Registration fees

Indicate which day you are coming to PAC: All Friday Saturday Sunday

Indicate below your registration type.

Please note all amounts quoted are in Australian Dollars (AU$) and include 10% Goods and Services Tax (GST).

REGISTRATION TYPE FULL REGISTRATION FULL REGISTRATION WITHOUT GALA DINNER TICKET

DAY DELEGATE

PSA Member $899.00 $799.00 $350.00

PSA Non Member $1124.00 $1024.00 $450.00

Early Career Pharmacist* PSA Member

$550.00 $450.00 $180.00

Early Career Pharmacist* Non Member

$650.00 $550.00 $225.00

Entry to conference sessions ü ü üon selected day only

Entry to trade exhibition ü ü üon selected day only

Morning and afternoon tea ü ü üon selected day only

Lunch ü ü üon selected day only

Welcome reception ü ü ü for Friday day delegates only

Gala Dinner ü No – Gala Dinner ticket =$120.00 No – Gala Dinner ticket =$120.00

Meet the profession cocktail party No – Meet the profession ticket = $40.00 No – Meet the profession ticket = $40.00 No – Meet the profession ticket = $40.00

Conference satchel ü ü No

* An Early Career Pharmacist is a pharmacist within the first 10 years of practice. (Evidence required.)

Please print clearly and return completed form with payment to:Pharmacy Australia Congress Secretariat – Ozaccom+ PO Box 104, RBH Post Office, Queensland 4029 AUSTRALIAT: 1800 814 611 » F: +61 (0)7 3854 1507 » E: PAC13@ozaccom.com.au

Register online at www.psa.org.au/pac

PAC13 REGISTRATION FORM

Section B Sub-total AU$

Defence Health Service and AACP Clinical Forum registration

REGISTRATION TYPE DEFENCE HEALTH SERVICE FULL REGISTRATION

DEFENCE HEALTH SERVICE DAY REGISTRATION

AACP CLINICAL FORUM**

Cost $899.00 $300.00 $350.00

Entry to MILSIG Day ü ü N/A

Entry to AACP Clinical Forum N/A N/A ü

Entry to trade exhibition ü N/A N/A

Morning and afternoon tea ü üon selected day only üon selected day only

Lunch ü üon selected day only üon selected day only

Welcome reception ü N/A N/A

Gala Dinner ü NO – Gala Dinner ticket = $120.00 NO – Gala Dinner ticket = $120.00

Meet the profession cocktail party NO – Meet the profession ticket = $40.00 NO – Meet the profession ticket = $40.00 NO – Meet the profession ticket = $40.00

Conference satchel ü N/A N/A

**AACP Clinical Forum is not included in the full or day registration types, it is a separate registration type

Section B Sub-total AU$

Section C: Inclusive social events

The welcome reception is included in your registration fee (for full delegates). For catering purposes, please indicate attendance by ticking appropriate box.

Welcome reception Attending Not attending

Gala Dinner Attending Not attending (not included in registration without dinner)

Section D: Additional social event/tickets

Please indicate the number of additional tickets required for the following functions along with tickets to optional functions.

NUMBER OF TICKETS COST PER TICKET TOTAL

Welcome reception AU$50.00

Gala Dinner AU$120 .00

Meet the profession cocktail party AU$40 .00

Welcome reception (for GDS13 delegates only) AU$85 .00

Farewell drinks (for GDS13 delegates only) AU$50 .00

Section D Sub-total AU$

Full registration includes session attendance, admission to the industry exhibition, morning and afternoon tea and lunch, delegate satchel, tablet computer, the welcome reception and Gala Dinner (where indicated in the registration type).

Day registration includes session attendance, admission to the industry exhibition, morning and afternoon tea and lunch on the day of registration.

Defence Health Service full registration includes session attendance at Thursday Military program, PAC session attendance, admission to the industry exhibition, morning and afternoon tea and lunch, delegate satchel, tablet computer, the welcome reception and Gala Dinner.

Defence Health Service day registration includes session attendance at Thursday Military program, morning and afternoon tea and lunch on Thursday 10 October.

Section E: Accommodation

This section is optional for delegates who wish to book their accommodation through Ozaccom+.Please indicate your preference below (King/Queen = single/double) You have the option to use this brochure to book your accommodation at the rates displayed however, we recommend you go to the online registration form where you can book the conference rate or select the best rate of the day.

HOTEL DISTANCE FROM BCEC

ROOM TYPE BEDS PRICE PER NIGHT

Rydges South Bank ««««½ Adjacent Standard Queen Room Queen AU$239 .00

Mantra South Bank ««««½ Adjacent Hotel Room King Twin AU$229 .00

Studio King Twin AU$249 .00

Studio City View King Twin AU$269 .00

One Bedroom Apartment King/Queen Twin AU$299 .00

Two Bedroom Apartment Queen Twin AU$479 .00

Oaks Casino Towers ««««½ 10 mins One Bedroom Apartment Queen Twin AU$239 .00

Two Bedroom Apartment 2 x Queen Queen + Twin AU$299 .00

Riverside Hotel «««« 10 mins Standard Room

One Bedroom Apartment King/Queen

King/Queen

AU$139 .00

AU$179 .00

Mercure Brisbane «««« 12 mins City View Room Queen Twin AU$200 .00

Ibis Brisbane «««½ 12 mins Standard Room Queen Twin AU$170 .00

Rendezvous Studio Hotel «««« 20 mins Deluxe Room King Twin AU$189 .00

Hotel George Williams «««½ 20 mins Double Room Double AU$155 .00

Queen Room Queen AU$180 .00

Superior Room Queen AU$210 .00

Sofitel Brisbane Central ««««« 20 mins Superior Room King Twin AU$260 .00

Traders Hotel Brisbane «««« 25 mins Deluxe Room King/Queen Twin AU$200 .00

Novotel Brisbane ««««½ 30 mins Standard Room Queen Twin AU$220 .00

Arrival (check in) Date: . . . . . . . . . . ./10/2013 Time: .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Departure (check out) Date: . . . . . . . . . . ./10/2013 Time: .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Please identify if you will be accompanied by or will share a room with another person:

..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Special requests (e.g., cots, smoking): .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Accommodation reservation deposit

Accommodation bookings can be secured by providing your credit card details or a deposit of one night’s tariff payable by cheque or money order. Please note, Ozaccom+ will not debit your credit card for the accommodation, however the accommodation venue may, at its discretion, debit the card for the deposit.

Please guarantee my accommodation booking using the credit card provided below or

Deposit of one night’s accommodation is included with payment on this form

*Please note: All accommodation rates are listed in Australian dollars and are valid for PAC13 and GDS13 only if booked through Ozaccom+. Rates include GST. Accommodation rates are per room per night. Rates and all information are current at time of printing and are subject to change without prior notification. Bookings made after 9 September 2013 may be subject to further terms & conditions. Accommodation cancellation in whole or in part less than 30 days prior to arrival may incur a penalty of one or more night’s accommodation cost at the venue’s discretion.

Alternative accommodation is available please contact Ozaccom to discuss the various options or register online and see the rates of the day.

PSA

3947

ONE | profession, focus, voice

PSA

3947

This registration form is a tax invoice ABN 49 008 532 072 | Please note: All fees quoted are in Australian Dollars and are inclusive of GST.

Cancellation and refund Policy:Cancellations for registration and accommodation will only be accepted in writing. Registration cancellations made prior to 1 September 2013 will be refunded less 20% to cover administration costs. No registration refunds will be made after this date. As an alternative to cancellation, your registration may be transferred to another person without penalty. Accommodation venues, at their discretion, may charge the full accommodation cost if cancellations are made less than 30 days prior to the check in date.

Regrettably, optional social functions and additional ticket cancellations cannot be refunded if participation is cancelled less than fifteen (15) days prior to the event.

Privacy Statement Please note that in registering for this Conference relevant details will be incorporated into a delegate list for the benefit of all delegates, and may be available for parties directly related to the Conference including Ozaccom+, the Local Organising Committee, venues and accommodation providers (for purposes of room bookings and Conference activities) and sponsors (subject to conditions).

If you do not wish your details to be made available to fellow delegates, please tick this box

Section F: Payment

Subtotal Section B: Registration AU$

Subtotal Section D: Additional social function tickets AU$

Subtotal Section E: Accommodation deposit (cheque payments only) AU$

TOTAL PAYMENT AU$

Payment Options

Please find enclosed my cheque made payable to Ozaccom+ Pty Ltd. Direct Debit and Electronic Funds Transfer

Please contact Ozaccom+ on +61 (0)7 3854 1611 for Direct Debit and EFT details.

Please debit my credit card for AU$:..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mastercard Visa AMEX Diners

Name on card: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Card number: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Expiry date: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Cardholder’s signature: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CCV: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

The organisers of PAC13 would like to thank the generosity of this year’s partners.

PAC13 SUNDAYWORKSHOPS

BRISBANE CONVENTION & EXHIBITION CENTREONE | profession, focus, voice

PSA

3988

Delegate details

Name: ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Email: ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Phone: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Completed forms can be set to:

Ozaccom+E: pac13@ozaccom.com.au P: 07 3854 1611F: 07 3854 1507

9.00am –10.30am Attending

Clinical Interventions workshop

Cardio Vascular Disease, evidence, practice and consumer

Ouch – that hurts. Every day Pharmacy – working with minor ailments

Male mental health

Medscheck workshop

Smoking cessation

11.00am – 12.30pm Attending

Clinical Interventions workshop (Rpt)

Contributed Papers 20 x 5 mins each

Ouch – that hurts. Every day Pharmacy – working with minor ailments (Rpt)

Male mental health (Rpt)

Medscheck workshop (Rpt)

Wound Care management practical procedures workshop in pharmacy

13.30pm – 15.30pm Attending

Smoking cessation (Rpt)

Pharmacists working in Government

Wound Care management (RPT)

Please tick the box to indicate which workshops you will be attending. Please note: only one workshop can be selected per section since workshops are running at the same time.