Program Highlights:

Transcription

1 Symposium Chair Mark S. Nestor, MD, PhD Session Directors Michael H. Gold, MD David J. Goldberg, MD, JD Mark D. Kaufmann, MD Mark G. Lebwohl, MD Henry I. Lim, MD Z. Paul Lorenc, MD Stephen H. Mandy, MD Gary D. Monheit, MD Mark S. Nestor, MD, PhD Faculty David J. Goldberg, MD, JD Mercedes E. Gonzalez, MD Ronald Hansen, MD David Herold, MD Bruce E. Katz, MD Mark D. Kaufmann, MD Jonette E. Keri, MD, PhD Robert I. Kirsner, MD Marina Landau, MD Mark G. Lebwohl, MD Henry I. Lim, MD Z. Paul Lorenc, MD Stephen H. Mandy, MD Gary D. Monheit, MD Rhoda S. Narins, MD Mark S. Nestor, MD, PhD Michael L. Nestor, ISD Margaret C. Oliviero, ARNP, MSN Program Highlights: Clinical and Surgical Dermatology Sessions Cutting-edge Aesthetic Dermatology Sessions Futures Symposium on Innovations in Dermatology Over 10 hours of Advanced Live Patient Workshops featuring Fillers, Toxins and Devices Pre-Conference Masters of Pediatric Dermatology Symposium Full-day Certification Course for Superficial Radiation Therapy Special Session with Prominent Industry Leaders on the Future of Medicine Dermatology Maintenance of Certification Session Investor Summit Back by popular demand! Benjamin Ascher, MD Brian Berman, MD, PhD Neal D. Bhatia, MD Roger I. Ceilley, MD Clay Cockerell, MD David E. Cohen, MD Joel L. Cohen, MD Zoe D. Draelos, MD James Q. Del Rosso, DO Glynis R. Ablon, MD Benjamin Ascher, MD Eric Billy Baum, MD Brian Berman, MD, PhD Diane S. Berson, MD Neal D. Bhatia, MD Theresa Cao, DO Roger I. Ceilley, MD Clay Cockerell, MD David E. Cohen, MD Joel L. Cohen, MD Doris Day, MD Steven Dayan, MD James Q. Del Rosso, DO Zoe D. Draelos, MD Julius Few, MD Dore J. Gilbert, MD Michael H. Gold, MD Darrell S. Rigel, MD, MS Theodore Rosen, MD Neil S. Sadick, MD Lawrence A. Schachner, MD David L. Wagener, MBA, CPA Susan H. Weinkle, MD Robert A. Weiss, MD David M. Pariser, MD Harold S. Rabinovitz, MD Marta I. Rendon, MD Darrell S. Rigel, MD, MS Theodore Rosen, MD Frank Rosengaus, MD William I. Roth, MD Neil S. Sadick, MD Lawrence A. Schachner, MD Arthur Swift, MD Darlene L. Tomlinson, MBA, MHL Abel Torres, MD Antonella Tosti, MD Andrea Trowers, MD David L. Wagener, MBA, CPA Susan H. Weinkle, MD Robert A. Weiss, MD Allan S. Wirtzer, MD The South Beach Symposium (Program #20113) is recognized by the American Academy of Dermatology for 36 AAD Recognized CME Credit(s) and may be used toward the American Academy of Dermatology s Continuing Medical Education Award Humberto Antunes Chairman and CEO Galderma Laboratories Robert Grant Chairman and Managing Partner Strathspey Crown Chief Executive Officer ALPHAEON Corporation Dermatology CEO Forum Guest Faculty J. Michael Pearson Chairman of the Board and Chief Executive Officer Valeant Pharmaceuticals International, Inc. Eduardo Javier Sanchiz Yrazu Chief Executive Officer Almirall Jonah Shacknai Former Chairman and CEO Medicis Pharmaceuticals More faculty being added!

2 WELCOME Don t Miss Out Make Plans to Attend! You are cordially invited to attend the 14th Annual South Beach Symposium at the Fontainebleau Miami Beach Hotel. The Symposium offers approximately 36 hours of continuing education credits and features cutting-edge dermatology educational sessions featuring the following CME tracks: Clinical Dermatology Symposium The Clinical Dermatology Symposium will host the world s top medical and surgical dermatology faculty to cover topics ranging from advances in clinical and therapeutic dermatology, photodynamic therapy, detection and treatment of skin cancer, emerging therapies for psoriasis, onychomycosis, urticaria, acne, rosacea, atopic dermatitis, actinic keratosis, wound care management and much more. Aesthetic Dermatology Symposium The Aesthetic Dermatology Symposium will present innovations in aesthetic procedures and technologies through multiple live patient demonstration and certification workshops given by world leaders in cosmetic and aesthetic dermatology. Practice Management Symposium The Practice Management Symposium will include an interactive session on elements to improve both clinical and cosmetic practice, EMR and imaging solutions, patient loyalty and retention programs and risk management strategies. While at the meeting, you can take advantage of the many cultural activities and events Miami has to offer including the Miami International Boat Show, the Coconut Grove Arts Festival and Art Wynwood. President s Day Weekend in Miami Beach is the perfect time to visit for not only these exciting events but also the optimal weather average temperatures are in the 70s during the month of February. The 2016 Symposium will once again prove to be an educational event you cannot afford to miss, we hope you will make plans to joins us. We expect the Symposium to sell out, so please register early! Mark S. Nestor, MD, PhD Symposium Chair This is a wonderful clinical meeting, with current and relevant updates on Medical Dermatology, Surgical Dermatology, and Cosmetic Dermatology. All the latest literature and devices are reviewed and the faculty is excellent. EARN UP TO 35+ CME/CE CREDITS 1

3 ACCREDITATION Who Should Attend? The South Beach Symposium is designed to meet the needs of physicians, nurses, and professional staff members of medical practices specializing in dermatology, plastic surgery, cosmetic surgery and other dermatologic medical procedures. Learning Objectives After participating in this program, attendees will be better able to: PEDIATRIC Recognize common and important skin disorders in African-American infants, children and adolescents. Identify the preferred form of therapy for psoriasis and other skin disorders in children. Choose appropriate therapies for hair growth issues in children. Review the available systemic therapies available for moderate to severe atopic dermatitis in children. Identify practical and effective ways to improve tolerability of topical and systemic treatments of acne in adolescents. MEDICAL Define current trends associated with clinical dermatology. Review common skin conditions including acne, psoriasis, rosacea and hyperpigmentation and how to effectively diagnose and treat them. Define and evaluate new treatment algorithms for melanoma and basal cell carcinoma. Identify and assess current and emerging therapies and their role in treating psoriasis. Review the mechanism(s) of action, safety and efficacy of treatment options for chronic idiopathic urticaria. Identify the benefits of early diagnosis of onychomycosis and understand the currently available as well as emerging oral and topical therapies to treat various patient populations. Identify new frontiers in topical therapies, prescriptions, OTCs and cosmeceuticals. Review basic dermatologic surgery techniques and surgical wound management. AESTHETIC Demonstrate advanced techniques in the use and application of various neurotoxins and dermal fillers. Recognize how to prevent and treat complications stemming from a variety of aesthetic procedures. Compare the latest advanced techniques in lasers, light and radiofrequency devices. Describe the latest advances in photodynamic therapy. PRACTICE MANAGEMENT Identify the rules, regulations, practice management techniques and business information necessary for a successful medical practice. Review risk management strategies for reducing the frequency and severity of malpractice claims. Accreditation and Credit Hours Physicians This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and The Skin Disease Research and Education Foundation, Inc. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians. AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 36 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity. Activity is jointly-provided by AKH Inc., Advancing Knowledge in Healthcare and The Skin Disease Research and Education Foundation, Inc. Criteria for Success Statements of credit will be awarded based on participant attendance, completion of registration for credit form and evaluation form, and may be generated at the evaluation kiosk located at the event. Please note: The agenda, faculty and CME/CE hours are subject to change. If you have questions about this CME/CE activity, please contact AKH Inc. at tbrignoni@ akhcme.com. The South Beach Symposium (Program #20113) recognized by the American Academy of Dermatology for 36.5 Recognized CME Credit(s) and may be used toward the American Academy of Dermatology s Continuing Medical Education Awards. Physician Assistants NCCPA accepts AMA PRA Category 1 Credit from organizations accredited by ACCME. Nursing AKH, Inc., Advancing Knowledge in Healthcare is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation. This activity is awarded 36 Contact Hours. Commercial Support & Faculty Financial Disclosure Full notification of support will be indicated in the meeting syllabus. Disclosure Declaration It is the policy of the Skin Disease Research and Education Foundation and AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflict of interest is resolved by SBS and AKH prior to accreditation of the activity. The Skin Disease Research and Education Foundation and AKH planners and reviewers have no relevant financial relationships to disclose 2

4 PROGRAM AGENDA THURSDAY, FEBRUARY 11 8:30 am 3:00 pm Masters of Pediatric Dermatology Symposium Session Director: Room A Lawrence Schachner, MD Vascular Lesions in Kids Hair Issues in Children Emerging Therapies in Children Skin Disorders Acne Therapy for Adolescents Atopic Dermatitis for Children Treating Skin Problems in African American Children 8:30 am 2:00 pm Superficial Radiation Therapy: Session Directors: Certification Course for Dermatology Mark S. Nestor, MD, PhD Room B and David J. Goldberg, MD, JD Radiation Physics, Devices and Technology Literature Review Tumor and Patient Selection Coding, Documentation and Regulatory Compliance Reimbursement Clinical Applications: Keloid Scars and NMSC 5:00 pm 6:00 pm Special Symposium: Advances in the Diagnosis and Session Director: Treatment of Melanoma Clay Cockerell, MD Diagnostic Advances Dermatopathology Treatment Algorithms for Melanoma 5:00 pm 7:00 pm Dermoscopy: Advances in Technique and Technology Session Directors: Room B Harold S. Rabinovitz, MD and Margaret C. Oliviero, ARNP 6:00 pm 7:00 pm Dermatology Mini MBA: Symposium I Session Director: Mark D. Kaufmann, MD Healthcare Reform ICD-10, Coding, Documentation Legal Issues, Malpractice Management Electronic Health Records 7:00 pm-8:00 pm Welcome Reception with Exhibitors For more session details, see page 8 8:00 pm 9:30 pm Satellite Symposium I: Dinner Served A Case Based Exchange Focused on Treatment Challenges in Moderate to Severe Psoriasis CME provided by Paradigm Medical Communications For more session details, see page 8 FRIDAY, FEBRUARY 12 6:00 am 7:30 am Satellite Symposium II: Breakfast served Recent Advances and Emerging Trends in Onychomycosis Management CME provided by Paradigm Medical Communications For more session details, see page 8 7:30 am 8:30 am Innovations in Clinical Therapeutics I Session Director Brian Berman, MD, PhD Wound Healing Onychomycosis Innovations in Clinical Therapeutics 3 *Agenda and Faculty Subject to Change*

5 PROGRAM AGENDA 8:30 am 10:00 am Acne Symposium Session Directors: James Q. Del Rosso, DO and Diane S. Berson, MD Optimizing Acne Therapy Adult Female Acne Pediatric Acne Antibiotic Therapy Panel Discussion 10:00 am 10:45 am Refreshment Break with Exhibitors 10:45 am 11:00 am American Academy of Dermatology Update Mark G. Lebwohl, MD 11:00 am 1:00 pm Futures Symposium: Session Director: Innovations in Clinical and Aesthetic Dermatology Brian Berman, MD, PhD 1:00 pm 1:45 pm Lunch with Exhibitors Pharmaceutical Breakthroughs Topical Actives and Sunscreens Injectable Body Contouring Advances in Dermatopathology OTC Light Therapy for Acne and Antiaging 1:45 pm 2:15 pm Innovations in Photodynamic Therapy Session Director: Neal D. Bhatia, MD Actinic Keratosis Update on PDT Panel Discussion 2:15 pm 3:15 pm Innovations in Clinical Therapeutics II Session Director: David E. Cohen, MD, MPH Emerging Therapies in Rosacea Topical and Oral Anti-oxidants and Anti-inflammatories Atopic Dermatitis Facial Erythema 2:15 pm 3:15 pm Resident Meet the Experts Session: Room B 3:15 pm 3:45 pm Refreshment Break with Exhibitors 3:45 pm 4:50 pm Special Symposium: Advances in Psoriasis Therapy Session Director: Mark G. Lebwohl, MD Biologics Combination Therapy Emerging Therapies for Psoriasis Panel Discussion 4:50 pm 5:20 pm Dermatology Bread & Butter: Session Director and Moderator: New Literature and Pearls: 15 Conditions in 30 minutes Theodore Rosen, MD *Agenda and Faculty Subject to Change* 4

6 PROGRAM AGENDA 5:20 pm 7:00 pm Special Symposium: The Science of Topical Therapy Session Director: RX, OTC and Cosmeceuticals Zoe D. Draelos, MD Topical Therapy New Treatment Kits Hair Growth Private Label Dispensing New Topical Formulations Therapy for Hyperpigmentation Growth Factors 7:00 pm 8:00 pm Wine Tasting Reception with Exhibitors 8:00 pm 9:30 pm Satellite Symposium III: Dinner Served Expert Guidance on New Developments Advancing the Care of Post-Acne Scarring CME provided by Paradigm Medical Communications For more session details, see page 8 SATURDAY, FEBRUARY 13 6:30 am 7:30 am Satellite Symposium IV: TBD Breakfast served 8:00 am 12:00 pm Non-CME Investor Summit : Session Director: Room B Jason Caron, JD Present and Future Challenges in Pharma Pharmaceuticals Development Medical Devices Physician Dispensing Investor s Perspective Reimbursement Trends Activity at the FDA Compliance Issues: Sunshine Act, Claims Integrity For more session details, see page 8 7:30 am 8:30 am IMCAS Symposium: Global Aesthetics Session Director: Benjamin Ascher, MD Aesthetic Anatomy Injectable Facial Rejuvenation from a Global Perspective Fillers From Across the World 8:30 am 10:00 am Toxins and Fillers I Session Director: Didactics and Advanced Live Patient Workshop Gary D. Monheit, MD Certification Course Avoiding Complications Patient Comfort Topical Anesthetics Live Patient Treatments Commentary 10:00 am 10:45 am Refreshment Break with Exhibitors 10:45 am 1:15 pm Non-CME: Devices in Aesthetics Session Directors: Advanced Technique Live Patient Workshop Michael H. Gold, MD and Robert Weiss, MD 5 *Agenda and Faculty Subject to Change*

7 PROGRAM AGENDA 1:15 pm 2:45 pm Non-CME: CEO Forum: Assuring Innovation, Access Moderator: Lunch served and Affordability in Therapeutics and Aesthetics Mark S. Nestor, MD, PhD Lifetime Achievement Award Presented to Jonah Shacknai, Former Chairman and CEO, Medicis Pharmaceuticals For more session details, see page 8 2:45 pm 3:30 pm Refreshment Break with Exhibitors 3:30 pm 5:00 pm Toxins and Fillers II Session Director: Didactics and Advanced Live Patient Workshop Susan H. Weinkle, MD Certification Course Optimizing Toxin Technique Calcium Hydroxapatite Live Patient Treatments Commentary 5:00 pm 7:00 pm Aesthetic Innovations II Session Director: Joel L. Cohen, MD New Aesthetic Devices PRP and Micro-needling Fillers for Acne Scarring Skin Tightening Injection Pearls Devices for Targeted Lipolysis Cellulite Treatments 7:00 pm 8:00 pm Satellite Symposium V: TBD Reception 8:00 pm 10:00 pm South Beach Gala SUNDAY, FEBRUARY 14 6:30 am 7:30 am Satellite Symposium VI: TBD Breakfast served This is my 4th time attending SBS and I have totally enjoyed the quality and appropriateness of the presentations. Thank you for orchestrating such a comprehensive, thorough, and broad range of dermatological topics. I enjoyed the conference very much as it continues to be one of the best conferences I attend each year. 7:00 am 7:30 am Continental Breakfast with Exhibitors 7:30 am 8:30 am Cutaneous Oncology: Joint Session ACOS Session Director: Darrell S. Rigel, MD Treating Actinic Keratosis New Melanoma Treatment Algorithm Superficial Radiation Therapy for Dermatology Advances in Treatment of NMSC 8:30 am 9:30 am Clinical and Surgical Innovations Session Director: Henry Lim, MD Urticaria Onychomycosis Surgical Wounds and Xenografts Photodamage and Dyspigmentation 9:30 am 10:30 am Refreshment Break with Exhibitors *Agenda and Faculty Subject to Change* 6

8 PROGRAM AGENDA 10:30 am 11:30 am Aesthetic Innovations III Session Director: Stephen H. Mandy, MD New Aesthetic Devices Aesthetic Correction of the Nose Innovations at IMCAS 11:30 am 1:00 pm Toxins and Fillers III Session Director: Didactics and Advanced Live Patient Workshop Z Paul Lorenc, MD Certification Course Dealing with Complications Facial Volume Replacement Permanent Fillers Live Patient Demonstrations Commentary 1:00 pm 4:00 pm Dermatology Mini MBA: Practice Management Session Directors: Lunch served Room B David L. Wagener, MBA, CPA Mark D. Kaufmann, MD The Evolving Dermatology Practice Enhancing Office Function Malpractice Risk Management Computers and Digital Imaging Insurance and Regulatory Update Coding and Documentation Update EPM and EHR 1:00 pm 2:30 pm Toxins and Fillers IV Session Director: Lunch served Didactics and Advanced Live Patient Workshop Joel L. Cohen MD Certification Course Live Patient Treatments Commentary 2:30 pm 3:30 pm Dermatology Mini MBA: Symposium II Session Director: David J. Goldberg, MD, JD Lessons from a Cosmetic Practice The Real Costs of Procedures Cosmeceutical Dispensing Technology and Practice Enhancement 3:30 pm 4:00 pm Surgery and Aesthetics Bread & Butter: Session Directors: New Literature and Pearls: 15 Issues in 30 minutes Susan H. Weinkle, MD and Roger I. Ceilley, MD 4:00 pm 5:30 pm Advanced Sclerotherapy Techniques Session Director: Didactics and Advanced Live Patient Workshop Neil S. Sadick, MD Certification Course Leg Vein Anatomy Optimizing Sclerotherapy Live Patient Treatments Commentary 7 *Agenda and Faculty Subject to Change*

9 FEATURED SESSIONS Masters of Pediatric Dermatology Symposium Thursday, February 11 8:30 am 3:00 pm Session Director: Lawrence A. Schachner, MD This one-day course will provide attendees with the latest research and advancements in skincare diseases in the pediatric adolescent patient. Topics include psoriasis, acne, atopic dermatitis, vascular lesions and hair issues in children and adolescents. Content was definitely current and scientifically excellent. Earn 3 Additional CME/CE Hours Investor Summit Saturday, February 13 8:00 am 12:00 pm Session Director: Jason Caron, JD Back by popular demand, this session will provide investors and executives with an understanding of how to navigate the complex business of buying, selling and investing in the dermatology and aesthetic medicine industries. The Summit will discuss current trends including practice management, roll-up and integration, new product innovation and the effect of the ever-changing managed care, reimbursement and regulatory environments. SATELLITE SYMPOSIA Non-CME: CEO Forum: Assuring Innovation, Access and Affordability in Therapeutics and Aesthetics Saturday, February 13 1:15 2:45 pm Session Director: Mark S. Nestor, MD, PhD Dr. Nestor will lead a panel of the most prominent Industry executives as they share their insight on the clinical, regulatory and economic challenges associated with the evolution of healthcare and its impact on dermatology and aesthetic medicine. Members of the SBS faculty will also serve on the panel to provide a unique interactive discussion between the executives and faculty members. A Lifetime Achievement Award will be presented to Jonah Shacknai, Former Chairman and CEO of Medicis Pharmaceuticals. Stay tuned for announcements on invited panelists! A Cased Based Exchange Focused on Treatment Challenges in Moderate to Severe Psoriasis This activity is supported by an educational grant from Celgene Corporation. Thursday, February 11 8:00 9:30 pm Dinner served Learning Objectives: Recognize the characteristics of different severity levels of psoriasis. Review appropriate treatment selection for moderate to severe psoriasis based on characteristics of available therapies and patient characteristics. Describe effective strategies to address barriers to treatment adherence among patients with psoriasis. Recent Advances and Emerging Trends in Onychomycosis Management This activity is supported by an educational grant from Fougera Pharmaceuticals, Inc. Friday, February 12 6:00 7:30 am Breakfast served Learning Objectives: Describe how the microbiologic etiology of onychomycosis relates to diagnosis and informs treatment selection. Distinguish current and emerging topical, systemic, and mechanical treatments for the subtypes of onychomycosis, including their benefits and limitations, mechanisms of action, dosing regimens, and efficacy and safety profiles. Discuss strategies for appropriate treatment of onychomycosis, including a focus on prevention of relapse, reinfection, and recurrence, as well as patient education. Expert Guidance on New Developments Advancing the Care of Post-Acne Scarring This activity is supported by an educational grant from Suneva Medical, Inc. Friday, February 12 8:00 9:30 pm Dinner served Learning Objectives: Review the benefits of a thorough evaluation of an individual s type and grade of post-acne scarring and skin type when determining the most appropriate treatment option. Summarize mechanisms of action, benefits and drawbacks, safety and efficacy of available and emerging treatment options for post-acne scarring. Describe principles for formulating plans to individualize treatment of post-acne scarring. Visit for more information on how to register for these satellite symposia. *Agenda and Faculty Subject to Change* 8

10 HOTEL & ATTRACTIONS Fontainebleau Miami Beach Hotel 4441 Collins Avenue Miami Beach, FL Hotel Reservation Deadline: January 7, 2016 The South Beach Symposium has arranged a special attendee rate of $425/night for a single/double occupancy plus an additional $19.95/night hotel fee at the Fontainebleau Miami Beach Hotel. Rates are subject to daily state and city taxes per room, per night. In order to book your hotel room you must register for the meeting first. Once you have completed the registration for the Symposium, you will be prompted to book your hotel reservations directly through the Fontainebleau Miami Beach Hotel online reservations system. Your confirmation will also contain the special reservation link. If for some reason you did not receive the link or your confirmation , please contact the SBS headquarters at Room specifications must be received by January 7, After this date, hotel availability and the discounted room rate cannot be confirmed. All room reservations require a credit card guarantee of one night s room, resort fee and tax as deposit at the time of booking. Guests may cancel or modify their reservation up until 5:00 pm ET on or before January 7, 2016 with no penalty. Any changes or cancellations to the room reservation made after January 7, 2016 cannot be refunded. The Fontainebleau Miami Beach Hotel will charge the credit card used to book your reservation in full for the amount of nights you have reserved for your stay after 5:00 pm ET on January 7, Any new reservations made after 5:00 pm ET on January 7, 2016 will be charged in full and will be non-refundable at the time the reservation is made. Area Attractions and Events 9 Miami International Boat Show February 11-15, The Miami International Boat Show is one of the world s largest boating exhibitions. The five-day event brings together thousands of the year s newest powerboats, engines, sailboats, electronics and marine accessories from more than 2,200 exhibitors at the best deals of the year. Coconut Grove Art Festival February 13-15, Experience one of the nation s premier outdoor fine art festivals. A signature event on the South Florida cultural calendar, the Festival offers visitors the opportunity to meet and talk with exhibiting artists, sample fine cuisine, enjoy live entertainment, take a walk through history, and, for the kids, create their own works of art. Ranked top 5 in America s Best Art Fairs! Art Wynwood February 11-15, Art Wynwood reflects the dynamic environment of Miami s burgeoning Wynwood Arts District, which over the last decade has gained international renown as the hub of South Florida s contemporary art scene. The fair will feature over 70 international galleries presenting emerging, cutting edge, contemporary and modern works. Graffiti artists from all over the world grace the walls of this edgy neighborhood with vibrant, provocative murals that set an energetic tone for the increasingly diverse galleries, restaurants and shops lining the sidewalks.

11 REGISTRATION South Beach Symposium Registration February 11 14, 2016 Fontainebleau Miami Beach First Name Middle Initial Last Name Affiliation Mailing Address City State or Province Zip Country Phone (required for confirmation) Fax Emergency Contact/Phone 2 3 Check all that apply: MD DO PhD RN PA ARNP PharmD Other Medical Specialty General Registration Fee Please check your appropriate classification. Registration fees include all lectures, course materials, and two tickets to all meeting events. Now until 12/15/15 Onsite starting 12/15/15 2/10/16 2/11/16 Physician $895 $995 $1,095 RN, NP, PA, Medical Staff $695 $795 $895 Industry Representative $1,395 $1,495 $1,595 Masters of Pediatric Dermatology Pre-Conference ONLY $200 $250 $300 Investor Summit ONLY $550 $650 $750 Residents (Must submit proof of residency) $0 $0 $0 Special Courses (Please choose between A or B as they are concurrent courses) A. Masters of Pediatric Dermatology B. Superficial Radiation Therapy Hotel Information Fontainbleau Miami Beach Hotel 4441 Collins Avenue Miami Beach, FL SBS Room Rate: $425/night + $19.95/night hotel fee Deadline: January 7, 2016 Any reservation received after this date cannot be guaranteed. How To Make A Reservation: In order to book your hotel room you must register for the meeting first. Once you have completed the registration for the Symposium, you will receive a confirmation that will contain an online reservation link to book your room directly with the Fontainbleau Miami Beach Hotel. If for some reason you did not receive the confirmation , please contact the SBS headquarters at Hotel Deposit And Cancellation Policies: Please refer to page 9 of this program brochure for hotel policies including deposit and cancellations. C. Maintenance of Certification D. Investor Summit 4 Guest and Social Events One guest badge included in registration fee. Please enter your complimentary guest s name below, plus any additional tickets needed for the South Beach Gala. Guest name Additional South Beach Gala tickets x $80 x $80 Social Events and Guest Total $ $ $ Meeting Registration: Registration and payment must be received no later than January 15, After this date a syllabus and name badge cannot be guaranteed-so register TODAY! Cancellation: Medical Conferences International, Inc. will offer a 100% refund within 72 hours from time of purchase less applicable credit card processing fee. After 72 hours refunds will be less 50%. All refunds must be made in writing and post marked or tax stamped no later than 90 days before the event. No refund will be made if the request is made within 90 days of the educational event. Refunds will not be issued to nonshow registrants. Substitutions are always welcome in lieu of cancellation for a $ transit fee. No transfers to alternate events will be made if the request is submitted within 90 days of the original event. Payment Total Payment (Combined Sections 2, 3,& 4) $ ADA Compliance: Attendees who need additional reasonable accommodations or who have special needs should contact the SBS at VISA Master Card AMEX Check (Make checks payable to: South Beach Symposium) Credit Card # Exp. Date Security Code Signature Registration Discount Disclaimer: Discount codes cannot be retroactively applied to existing meeting registrations. The meeting discount codes are applicable to new registrants only. Name on Card Three Convenient Ways to Register: FAX: MAIL: ONLINE: (904) South Beach Symposium Southpoint Pkwy., Suite 1000 Jacksonville, FL SBS16REG 10

12 6816 Southpoint Pkwy., Suite 1000 Jacksonville, FL February 11 14, 2016 Fontainebleau Miami Beach Hotel Miami Beach, FL EARN 35+ CME/CE HOURS! Follow us on Twitter and Facebook for Facebook.com/southbeachsympo Register Now at