Rheumatology Patient Education Conference (May 2024)
Sat. May 18, 8:30am to 2:00pm | Location: Leeward Community Church
1860 Komo Mai Drive, Pearl City
Plant-based lunch is included
Name
*
Email
This address will receive a confirmation email
Phone
*
Do you have a specific Rheumatoid disease that you would like more information on? If so, which disease(s)?
There will be a plant-based Lifestyle Medicine Teaching Kitchen. Do you have any allergies/dietary restrictions?
*
During the Fascinator roller session, participants will be on yoga mats. Do you need an accommodation?
*
Please select all that apply.
No
I can participate seated, using a table-top surface.
I need assistance during the roller activity.
Is there anything you are specifically interested in learning at this conference?
Would you be interested in attending a Geriatric Patient Education Conference in the future?
*
Please select one option.
Yes
No
Select Option
Yes
No
What topics would you be interested in for future Patient Education Conferences?
As part of the enrollment in the conference, please be aware that there will be photographers taking photos and videos of the activities throughout the day. Your enrollment serves as acknowledgement that you give permission and approval for your image to be used by Leeward Community Church and Hawaii Rheumatology Society in their efforts to bring patient education to the communities in which they serve.
*
Please select all that apply.
I understand and give permission and approval for my image to be used by Leeward Community Church and Hawaii Rheumatology Society.
Payment
$15.00
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
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Description
Sat. May 18, 8:30am to 2:00pm
Location: Leeward Community Church
1860 Komo Mai Drive, Pearl City
Plant-based lunch is included
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