You may register by either using our secure online form below,
      or by
downloading the PDF registration form.
Registrant Information:          
   * = Required Information
Name: *
Degree:
MD PhD PA DO NP RN OTHER
Medical Specialty:
Name of Institution:
Mailing Address – select one Work/Business    Home
Address: *
City: *
US State: *
State/Province (if outside US): *
Postal Code: *
Country:
Telephone: *
Fax:
E-mail: *
  (NOTE: E-mail is the Matrix Meeting’s primary form of correspondence.)
Special Needs:
If you have special assistance needs or dietary restrictions, describe here:
Type of credit that you are interested in receiving:
AMA/Category 1
Nursing
Perfusionist
Nurse Anesthetist
Un-TransFuse Conference – March 14, 2013 – 4:15 – 5:00 p.m.
Please select the session you plan to attend:
(no CME credit given at sessions marked with *)
Perioperative Anemia Management*
Heparin Induced Thrombocytopenia
Data and Metrics*
Civilian Lesson Learned from the Military
Laboratory Guided Algorithms
Star Trek Blood Bank
Algorithms, CPOE Rules in Non-Cardiac Surgery Transfusions
 
Optional Social Functions - Saturday, March 16, 2013
(Please indicate if you are interested in any of the following activities on
Saturday, March 16, 2013. Additional information will be provided to those who indicate interest).
Golf @ Wildfire Golf Club (J W Marriott Desert Ridge)
Hike @ South Mountain
Out of Africa Wildlife Park
Registration Fees: *
Physicians and Administrators:
March 13, 14 and 15 (no lab):
$500
March 13, 14 and 15:
$700 (includes March 13 hands on animal lab)
1 day registration
$350
Select 1 Day Registration Date:
March 13   March 14 March 15
Please indicate if you are a Mayo Clinic, Hartford Hospital, Cleveland Clinic, Loyola University employee or Military ( $100 discount ).
Residents, Physician Assistants, Nurse Practitioners, & Nurses
March 13, 14 and 15 (no lab):
$450
March 13, 14 and 15:
$650 (includes March 13 hands on animal lab)
1 day registration:
$300
Select 1 Day Registration Date:
March 13   March 14 March 15
Please indicate if you are a Mayo Clinic, Hartford Hospital, Cleveland Clinic, Loyola University employee or Military ( $50 discount ).
PATIENT BLOOD MANAGEMENT CERTIFICATION
(Wednesday, March 13, 1:30 – 5:15 p.m.)
$ 50.00    Remove
 
Reception on Thursday, March 13th
Two tickets are included in Registration Fee
Yes, I will attend (included in registration fee)
Yes, I will attend and bring one guest (included in registration fee)
# of additional tickets at $65 per adult
No, I will not be able to attend
Registration Total:  $
Privacy Statement
All information you supply will be used for the purposes of registration, correspondence or program information. Mayo Clinic reserves the right to photograph and/or record all conference participants and proceedings for later use in published or distributed conference materials.

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