Midas Rex® Institute

Hands-On Instruction Workshop

COURSE LOCATION:

Medtronic Powered Surgical Solutions, 4620 North Beach Street, Fort Worth, TX76137, Phone: 800-643-2773 or 817-788-6520. The main entrance is at the Northwest corner of the building. When you arrive please ask for Diane Poe or Krista Baird.

OTHER INFORMATION:

  • Hours for the workshop are7:30 a.m. - 5:00 p.m. Breakfast will be served at Medtronic at 7:00 a.m.
  • Cell phones or beepers are not to be worn during the course hours.
  • No open-toe shoes are allowed.
  • You will be provided scrubs at the hotel when you register; please come dressed in the Medtronic scrubs.
  • Standard surgical exam gloves will be furnished for use during the hands-on workshop. If you require special gloves because of allergies you will need to bring them. You will need 4 or more changes.
  • Breakfast and lunch will be provided.

HOTEL:

Downtown – Renaissance Worthington Hotel, 200 Main Street, Fort Worth, Texas76102, 817-870-1000.
**Please check out of your roomSunday morning unless otherwise noted**

TRANSPORTATION:

Silver West will provide transportation for course participants arriving via DFW. Please go to your designated baggage claim area and a Silver West greeter will be there with a Medtronic sign to direct you to the shuttle. They will also be at the hotel the morning of the course at 7:15 AM to bring everyone to Medtronic’s facility. They will in addition transport all course participants back to DFW after the course. Pick-ups have already been arranged but if any problems arise you may call Silver West directly at 817-870-1333 or call Diane Poe at 817-734-1043.

REGISTRATION PROCESS:
Please complete the following and return via fax(817-788-6287) or email to . This information will be used to complete/ confirm your registration, so please print or type your response. Once your completed form is received we will book your travel and hotel accommodations. You will receive an e-mail confirmation with your travel itinerary and hotel information. Please provide a fax number if email is not an available option.

Date of Midas Rex® Workshop: / November 20 - 22, 2009
Legal Name: / CHI D. HA, MD
PGY Training Level: / FELLOW - PGY6
Address (Including City, State Zip): / 1235 WILDWOOD AVE, APT #28; SUNNYVALE, CA94089
Phone:
(preferably cell for contact while here) / 717 460-3253
Email: /
Hospital Affiliation: / STANFORDUNIV.MED.CENTER & CLINICS
Scrub Size: / XL
Special Food Accommodations: / N/A
HomeAirportOf Choice: / SAN JOSE
Preferred Departure Time: / PM
Current Midas Products used/ Special Equipment Request / MIDAS REX
Sales Rep: / Sandra Kavanau

Please call or e-mail with any questions

or 817-788-6520

We look forward to seeing you!