5th Annual Blood Cancer Symposium September 6, 2014 Independence,OH Online Registration
You MUST complete one online registration form
for EACH person who will be attending. Once you complete your first registration, just go back to the same link and fill out a second form for additional attendees.
Email address (If you do not enter an email address, you will not receive any further updates about the Symposium)
Are you a
For Pt/Caregiver: What is the pt's diagnosis?
Date of Diagnosis
For Healthcare Professionals: Will you be requesting continuing education credits?
Yes - Nurse
Yes - Social Worker
I will need a certificate of attendance for another discipline
Please choose ONE morning breakout session (Conversations with the Doctors - Emerging Therapies) you would like to attend:
Myelodysplastic Syndrome (MDS)
Acute Leukemia (ALL and AML)
Chronic Lymphocytic Leukemia (CLL)
Chronic Myelogenous Leukemia (CML)
Non-Hodgkin Lymphoma (NHL) and Hodgkin Lymphoma
I will not be attending a morning session
Please choose ONE afternoon breakout session you would like to attend:
Understanding the Complete Blood Count: What it Means to You
Fear Not: Learning Techniques to Deal with Fear and Uncertainty
Understanding Blood & Marrow Transplantation
Cancer in Your 20's & 30's: Now What?
Nutrition During & After Treatment
Let’s Learn Zentangle® : A creative art form that can help reduce anxiety and increase mindfulness (This interactive session is for patients and caregivers only and is limited to 25 participants)
I will not be attending an afternoon breakout session
Will you be attending lunch?
Do you want a vegetarian lunch?
If you have any other dietary requirements, please explain:
If you need any special accomodations, please explain:
Is there anything else you need to tell us?
Indicates Response Required