HEALTHCARE SYSTEMS PROCESS IMPROVEMENT CONFERENCE 2012 REGISTRATION FORM ADVANCE


DEC. 6 - FEB. 8 SHS/HIMSS MEMBER NON-MEMBER* STUDENT** $695 $875 $155 AFTER FEB. 8 $795 $975 $215


*Non-member rate includes one-year membership in SHS. Membership becomes active at the conclusion of the conference.


** Student Registration -- You must be a full-time student with an accredited educational institution to be eligible for student rate. Students who are not IIE/SHS members must submit a copy of school schedule or letter from their institution with their completed registration form. A copy of student ID will not be accepted as proof of status.


Team Discount - Save up to $100 off each registration. Two to four people from the same company who register at the same time can deduct $50 off each conference registration fee. Five or more can deduct $100 each. Does not apply to the early-bird member, student or speaker rates.


Online registration will be available until Wednesday, February 8. After that time, please bring completed registration form to the conference.


Pre-Conference Workshops


Saturday, February 18 HALF-DAY WORKSHOPS


MEMBER/NON- MEMBER $195/$215


DEC. 6 - FEB. 8 ADVANCE


MEMBER/NON- MEMBER $235/255


8 A.M. - NOON cLEAN HOSPITAL – HOW TO TEACH LEAN TOOLS EFFECTIVELY IN HEALTHCARE V2.1


1 P.M. - 5 P.M. LEAN IN DAILY WORK – STANDARD WORK FOR DAILY PROBLEM SOLVING – TRAIN THE TRAINER


1 P.M. - 5 P.M. INPATIENT FLOW – LEARN & APPLY LEAN TECHNIQUES TO SOLVE PROBLEMS


SIGN UP FOR BOTH THE MORNING AND AFTERNOON WORKSHOP FOR ONLY $295-MEMBER /$315-NON-MEMBER


I WOULD LIKE TO DONATE TO THE SHS SCHOLARSHIP FUND $50


$25 $10


TICKETED EVENTS The following events are complimentary, but do require tickets for admission


I WILL ATTEND THE WELCOME RECEPTION ON SATURDAY, FEBRUARY 18


I WILL ATTEND THE NETWORKING RECEPTION ON SUNDAY, FEBRUARY 19 I WILL ATTEND THE JOINT RECEPTION WITH HIMSS ME-PI GROUP ON MONDAY, FEBRUARY 20


I WILL ATTEND THE LUNCHEON ON SUNDAY, FEBRUARY 19 I WILL ATTEND THE LUNCHEON ON MONDAY, FEBRUARY 20


I WOULD LIKE TO SERVE AS A STUDENT MENTOR AT THE CONFERENCE


AFTER FEB. 8 ON SITE


Register for hotel at www.himss.org. If you are going to attend both the Healthcare Systems Process Improvement Conference and the HiMSS conferences, register at the HiMSS 2012 Conference site to get conference savings of $100.


Conference registration fee includes: • Admission to all educational tracks with over 50 presentations • Keynote presentations • Luncheon with featured speakers • Welcome reception • Admission to exhibit area • Admission to vendor presentations and networking social • Continental breakfast on Sunday and Monday • A CD with conference proceedings • A conference tote bag • All the learning, networking and fun you want


Pre-conference workshops and hotel room fees are separate fees and are not included in registration fee.


Please complete: Mr.


Mrs. Ms.


Last/Surname First: Preferred first name on badge: Title: Company: Address: City:


Country: Please check one: Phone:


Dr. ON SITE


REGISTER ONLINE AND SAVE TIME www.shsconference.org


State/Prov Zip: Company address Fax:


E-mail: Yes, I require special assistance services. E-mail your request to cs@iienet.org.


Method of Payment: (Conference fees are due in full at registration in U.S. currency only.) Check – made payable to IIE


A check for $


Credit card – Please charge $ Visa


MasterCard Credit card #


Signature: Name of cardholder (print):


Cancellations and Substitutions: Cancellations must be made in writing and faxed to (770) 263-8532 or mailed to IIE, 3577 Parkway Lane, Suite 200, Norcross, GA 30092. See website for deadline for refund. Contact customer service at cs@iienet.org or (770) 449-0460x102 or (800) 494-0460.


is enclosed. Check # to my: American Express Exp. Date: Home address


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12