PRIMARY CARE SURGICAL ASSOCIATION

4thAnnual Scientific Meeting 2015, Dublin, Booking Form

Dublin 2015

REGISTRATION*
REGISTRATION TYPE* /

COST

/ PLEASE INDICATE NO.
Members of PCSA or ASPC before 01/09/15 /

€ 200

Member of PCSA or ASPC after 01/09/2015

/

€ 240

Non-member before 01/09/2015 /

€ 240

Non-member after 01/09/2015 /

€ 280

Trainee or Nurse Member before 01/09/2015 /

€ 150

Trainee or Nurse Member after 01/09/2015 /

€ 190

Trainee or Nurse Non-Member before 01/09/2015 /

€ 180

Trainee or Nurse Non-Member after 01/09/2015 /

€ 220

Friday only before 01/09/2015 (after this date=€140) /

€ 120

Saturday only before 01/09/2015(after this date=€180)

/

€ 160

Gala dinner Friday 25/09/2015 /

€ 50

TOTAL REGISTRATION FEE SUBMITTED:

Please indicate any dietary requirements:

*Registration fee includes all workshops, lectures, lunch on Saturday, coffee and tea breaks.

PAYMENTS PLEASE AS FOLLOWS:

Cheques payable to PCSA can be sent to: / Or pay by bank transfer:
Ms Olive Lynch, Meeting Administrator
Primary Care Surgical Association
The Ashe Street Clinic
Tralee, Co Kerry
Email:
Tel: 066 712 5611 / Primary Care Surgical Association
Account Number: 84339011
Bank Sort Code: 936219
IBAN: IE37AIBK 936219 84339011.
AIB, Castle Street, Tralee, Co Kerry
BIC: AIB KIE 2D

Please ensure that your name is included with any bank transfer and post the registration form to Ms Lynch to indicate registration, payment and workshop selection.

Cancellation Policy: Notice of cancellation for the meeting must be sent in writing or email to the conference administrator at the address above. Cancellation received before the 1st September 2015 will receive a 75% refund. Substitution can be made at the discretion of the Conference Committee. For accommodation cancellation, contact the hotel directly.

YOUR DETAILS:

Your name:Practice Name:

(Please print carefully)

Address:

Position (eg. GP, surgeon, dermatologist, practice nurse, etc.):

Areas of Special Interest (eg: skin cancer, vasectomy, radiosurgery, cosmetic, etc.):

Tel: Mob: Email:

CLINICAL RECORDS SOFTWARE USED: H1( )HelixPM ( )Socrates ( )CompleteGP ( ) Other (______)

Dublin 2015

Please re-enter your name:

Please book your accommodation directly with the Clontarf Castle Hotel.

Tel: 01 833 2321 or e mail :
Ask for PCSA rates and ensure to book up to six weeks before the meeting to guarantee a room at these rates:

Double B & B per room per night /

€ 169

Single B & B per room per night /

€ 159

Twin B & B per room per night

/

€ 169

Two night B & B with one dinner – single /

€ 354

Two night B & B with one dinner - double /

€ 390

WORKSHOP CHOICES

Places are limited and will be allocated on a first come, first serve basis. If you choose a workshop that is full we shall let you know so that you can select another.

Friday 25th September (3:00 to 5:00pm)

(Select two of the four workshops– one in each time slot)

(Please tick only one in each time slot) - 3:00 – 4:00pm 4:00 -5:00pm

1. Partial closure, buried sutures + subcuticular suture
2. Clinical photography

3. Tissue viability

4. Lesion recognition without a dermatoscope.
5. Community Rx of haemorrhoids

Saturday 26thSeptember(3:00 to 5:00 pm)

(Select two of the four workshops – one in each time slot)

(Please tick only one in each time slot) - 3:00 – 4:00pm 4:00-5:00pm

1. Elliptical excisions
2. Surgery on the face

3. Vasectomies

4. Simple skin surgery – punch and shave biopsy and curettage

Please return all pages to:

Ms Olive Lynch, Meeting Administrator, Primary Care Surgical Association, The Ashe Street Clinic, Tralee, Co Kerry

Email: Tel: 066 712 5611

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