Veterinary Trauma Critical Care Symposium

American College of Veterinary Emergency and Critical Care Held in conjunction with the

Trauma, Critical Care Acute Care Surgery Conference: April 7 & 8, 2018

Pre-conference VetCOT committee meetings: April 6, 2018

Caesars Palace Las Vegas, NV

REGISTRATION FORM

Register by or before March 16, 2018

Please Print or Type:

Name: VetCOT committee member: Yes No

Address (street, city, state, zip code):

Telephone:

Email address:

Practice Name: Veterinary Trauma Center: Yes No

Role in practice: Specialist: (college) DVM ACVECCT

Student Intern Resident Other:

Do you plan to attend the pre-conference VetCOT committee meeting, Friday, April 6th, 1:00-5:30 pm?

Yes No

Cost of ACVECC Postgraduate Review Conference (check applicable box):

DVM $175 Technician/Residents: $85.00

Resident rate applies to residents of ACVECC, ACVIM, ACVS, ACVR and any European specialties, interns and 2017 veterinary school graduates.

Optional

Attend Saturday dinner, April 7th @ Carmine’s ($50) Yes No

Attend Sunday luncheon, April 8th @ Disaster Medicine conference ($25) Yes No

(“London Under Siege: After Action Review with Lessons Learned – Westminster, London Bridge, Finsbury Park, Grenfell Tower”)

Travel, lodging, and registration for the Trauma, Critical Care Acute Care Surgery conference must be made separately by visiting the website at http://www.trauma-criticalcare.com. You do not have to attend the Trauma, Critical Care Acute Care Surgery to attend the Veterinary Trauma Critical Care Symposium. Rooms fill quickly, so booking early is strongly encouraged.

How to register for the Veterinary Trauma Critical Care Symposium:

For credit card payment, please email this completed form to . You will be sent a return e-mail with a credit card authorization form to complete. All completed credit card forms must be faxed to the secure ACVECC fax, attention Kathleen Liard, at (508) 887-4634. In order to protect your personal information, DO NOT EMAIL CREDIT CARD INFORMATION.

To pay by check, please complete and email this form to reserve your registration, and then copy and send this form with your check, made payable to “ACVECC” to:

Kathleen M. Liard, ACVECC Admin. Assistant, Cummings School of Veterinary Medicine at Tufts University, Dept of Clin Sci – FHSA, 200 Westboro Rd., North Grafton, MA 01536