2012 Breakfast for Brainiacs Audio Conferences

Site Coordinator's First and Last Name

Title

Agency Name

Address

Address 2

City

State

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware D.C. Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code

Phone

Email Address

Audio Conferences: If you are signing up for 6 sessions, you can choose the 6 audioconferences that you plan to attend (these choices can be changed later.)

Full Year Package 6 Month Package No Package/Individual Sessions Only

Breakfast for Brainiacs Schedule:

January 25 B4B - First Impressions are Everything: Assuring Our First Contacts Connect February B4B - Maximizing the Alzheimer's Tool Kit/THIS IS NOT ALZHEIMER'S: An Overview of Vascular Dementia, Lewy Body Dementia & Frontotemporal Dementia March 15 B4B - So What the Heck DO Social Workers DO? or Defining Social Work in Hospice and Palliative Care April 17 B4B - Advance Care Planning and MOST/POLST May 9 B4B - Quality Issues June 21 B4B - Cancer Treatment Complications in the Hospice Setting July 25 B4B - On the Edge: Maintaining Professional Boundaries August 15 B4B - Enhancing Documentation to Maintain Compliance September 12 B4B - Symptom Series: Management of Dyspnea in Our Hospice Patients October 24 B4B - Symptom Series: "Momma ain't been right all day. Is it the morphine?" Managing restlessness and delirium in hospice patients November 7 B4B - Symptom Series: Pain Management at the End of Life December 12 B4B - Family Dynmaics: Holiday Fear or Holiday Cheer?

Site Registration: All you need to participate is a phone or speaker phone. A site coordinator from each participating agency must be registered using the form below. Materials such as the call instructions, roster, handouts, and evaluations will be sent to each site coordinator prior to the audioconference. It is the responsibility of each site coordinator to copy and distribute materials to the additional participants on the call. After the completion of the audioconference, the site coordinator is responsible for entering all participants on the on-line roster, and for providing participants with the on-line location for completing the evaluation for this course. Rosters and evaluations must be entered by Wednesday following the audioconference, or a $25 late fee will be charged. Continuing Education: The Carolinas Center for Hospice and End of Life Care is an Approved Provider of continuing nursing education by the North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. 1.0 contact hours are available for nurses. This program is also approved for social workers through the South Carolina Board of Social Work Examiners. 1.0 contact hours are available for all others. Certificates of completion will be mailed to each site coordinator after The Carolinas Center receives the roster and evaluations from your site coordinator.