2008 Health Literacy Conference Registration Form

Attendee *required
*First Name (as you would like it to appear on your name badge) *Last Name Credentials (RN,PH.D, M.D. etc.) Company Title *Where did you hear about this conference? - Select -IHA WebsitePostcardEmail NoticeColleague ReferralAttended PreviouslyOther		*Address *City   *State       *Zip   *Country       *Work Phone    Ext       *Fax *E-Mail
*If Other selected please state below
Check this box if you DO NOT wish to have your name and professional affiliation shared with attendees in the Program & Proceedings book. If you do not check this box, your name and affiliation will appear.

BREAKOUT SESSIONS Click here for a description of each breakout session

April 30

FREE Pre-Conference Session: Health Literacy 101 (check whether you plan to attend) Attending Not Attending

May 1
Please Select 2 Sessions
Thursday 1-	Practical Strategies to Improve Patient
	Communication
Thursday 2-	Writing Easy to Read, Easy to Use Health Information
Thursday 3-	Assessing Quality of Translated Materials
Thursday 4-	Beyond the Focus Group: Tools for Involving
	Your Audience in Creating Materials
Thursday 5-	Overcoming Cultural Barrier to Health Literacy in a Clinical Setting

May 2
Please Select 2 Sessions
Friday 1-	Patient Action Plans: Baby Steps to Success
Friday 2-	Evaluating Websites for Reading Ease and User-Friendliness
Friday 3-	Communicating With the Elderly on Healthcare
	Issues
Friday 4-	Should I Hand This Out? Choosing and Using Patient Education
	Materials

ACCREDITATION
Type		Corresponding License No.
CE
CHES
CME
DCE (Dental)
PHARMD
CPE-RD
NONE REQUESTED

TUITION FEES
				Regular (after April 7, 2008)
Standard				$379
Non-Profit**				$349
3 or more from one Organization				$319
(per registrant, when registered & paid
for at the same time.)
**Includes education/governments/nonprofits

Payment Method
Please Select ONE payment method:
Tuition Fee:
Coupon Code
*Payment Method:		Check P.O. Credit Card ***Bill Me ***Sending Check
P.O. Number:
Credit Card Type:		Visa MC AmEx Discover
Credit Card # (ex. 1111-1111-1111-1111)		---
Expires:(ex. MM-YY)		/
Name on Credit Card
3 digit Security Code
Make Checks Payable to: IHA, send to 501 S.Idaho St., Suite 300, La Habra, C.A. 90631  ***Must be paid in full one week prior to Conference