October 29 - 31, 2021Amway Grand Plaza

22 AOA Category 1-A Credits Speakers, agenda & registration at www.domoa.org/autumn

2112 University Park Dr., Ste 100, Okemos, MI 48864domoa.org | P 517-347-1555 | F 517-347-1566

Name ____________________________________________________________________________________________ AOA Number _________________________________

Email address ____________________________________________________________ IMPORTANT: Please be sure to enter an email address where information regarding the programs can be sent to you.

PAYMENT: Credit card MasterCard Visa Discover Check # ___________ Made payable to MOA

Name on credit card ____________________________________________________________ Phone _________________________________________

Credit card number _________________________________________________________________Exp. date _____________ CVV code _______________

Billing Address ____________________________________________________________ City __________________________________ State________ Zip __________________

R E S E RVAT I O N S: $164 rate until Sept. 28, 2021 • Call 800-253-3590 • www.domoa.org/amwayPARKING: Amway overnight guests $16 valet/$10 self-park, not included in registration

Cancellation Policy: Requests for refunds must be in writing by mail or email by October 23, 2021 and will entitle registrant to a full refund less a $50 processing fee. MOA Statement of Accreditation: AOA Credit - The Michigan Osteopathic Association is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians. The MOA designates this program for 22 AOA Category 1-A credits and will report CME with the extent of the physician’s participation in this activity.

Online registration & agenda at D O M OA.O RG/A U T U M NThis form must be received in advance of the registration deadline October 18, 2021.

Credit card payment taken by phone, fax or online. Checks accepted by mail, made payable to MOA. RETURN TO: 2112 University Park Dr., Ste 100, Okemos, MI 48864

Sponsored in part by our Strategic Partners:

Michigan Osteopathic AssociationMOA

MICHIGAN OSTEOPATHIC ASSOCIATION

Autumn Scientific ConventionAutumn Scientific Convention

Michigan Osteopathic Association | 2112 University Park Dr., Ste 100, Okemos, MI 48864 | P 517-347-1555 | F 517-347-1566 | www.DOMOA.org

REGISTRATION, SPEAKERS & DETAILSwww.domoa.org/autumn

F R I DAY 9 am - 6 pm S AT U R DAY 8 am - 6 pm

S U N DAY 7 am - 1 pm

SESSION HIGHLIGHTS:22 AOA Category 1-A Credits

Sleep Apnea • Gastroenterology UpdateBusiness of Medicine • Hypertension in Geriatrics

Driver’s Rehabilitation • Cardiology UpdateChild/Adolescent Psychiatrist Addressing Pandemic

Basic Management of Parkinson’s Disease Lifestyle & Functional Medicine Sessions

Osteopathic Manipulative MedicineWomen’s Health

We’re carrying on with care. Join us for a long-awaitedin person event in Grand Rapids. If you are interested in virtual or on demand offerings, please visit domoa.org/meded.

Payment & registration completion on back.

Meal ScheduleFriday lunch break “on your own,” 12 - 1 pm

Saturday breakfast & coffee provided

Saturday lunch break, 12 - 12:30 pmOrder a boxed lunch - $25Sunday breakfast & coffee provided

Sunday “working” lunch, 12 pm Order a boxed lunch - $25Sunday program ends 1 pm

Early Bird registration until Oct. 18! Call 517-347-1555 to update membership for discounted rates.

MOA Member Early Bird Registration (until Oct. 18)Regular Registration (Oct. 19 - Oct. 31)MOA Retired MemberMOA Life Professional MemberIntern/Resident*, Student*Intern/Resident needing CME Credit

Non-memberDOMDNurse, other healthcare professional

$550$600$275$200FREE$75

$1,100$1,100$375

TOTAL (registration + boxed lunches) = ___________

REGISTRATION OPTIONS:

October 29 - 31, 2021Amway Grand Plaza187 Monroe Ave. NW, Grand RapidsReservations: Call 800-253-3590$164 rate until Sept. 28, 2021Diamond Sponsor