IDAMC Registration – 2017 | Mammoth Medical Missions | Providing medical and humanitarian aid to underserved rural and mountain communities worldwide.

Name*

First Name Last Name

E-mail*

Phone Number*

–Area Code Phone Number

Address*

Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country

Referred by, or how you discovered IDAMC:*

Medical license/specialty/experience/skill set*

Mass casualty, medical mission or other austere-environment medical experience*

Other relevant skills (foreign language, communications, infrastructure, etc.)

I would like to register for the following (choose only one):*

Full Seminar (HS/College Student, with MMM approval – limited to 5 seats): $150
Full Seminar (Paramedic, EMT, Tech, Resident, other): $500 early bird by May 31st, $750 after
Full Seminar (RN and PA): $750 early bird by May 31st, $1,000 after
Full Seminar (Physician): $1,000 early bird by May 31st, $1,500 after
Keynote only (based on seating limitations, 30 keynote-only seats available) $50 donation

Desired CME/CE credit*

* Includes relevant CE/CME credits for qualified participants. All proceeds benefit Mammoth Medical Missions, Inc., 501(c)3, and its ongoing mission to improve medical and surgical care for underserved populations and those affected by widespread disaster.

Payment

USD International Disaster & Austere Medicine Conference. Proceeds benefit Mammoth Medical Missions, Inc., 501(c)3

Slots will be filled on a first-come first-served basis. For detailed lodging and travel information see www.mammothmedicalmissions.org/idamc-logistics-2016/

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint providership of the University of Nevada School of Medicine and Mammoth Medical Missions. The University of Nevada School of Medicine is accredited by the ACCME to provide continuing medical education to physicians.

The University of Nevada School of Medicine designates this live activity for a maximum of 21.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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IDAMC Registration – 2017

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