egistration form

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Veterinary Therapeutics for Companion Animals
REGISTRATION FORM
Veterinary Therapeutics for Companion Animals list of Courses
□ Lecture 1: The Veterinary Profession, Dosage Forms and Veterinary Client Counseling (0.25 hrs)………………………
□ Lecture 2: Dosage Determination in Veterinary Medicine (0.25 hrs)………………………………………………………….
□ Lecture 3: Internal Medicine (1.25 hrs)…………………………………………………………………………………………..
□ Lecture 4: Poisoning and Toxicology (0.25 hrs)…………………………………………………………………………………
□ Lecture 5: Zoonoses: Human and Animal Relationships in Health (0.25 hrs)……………………………………………….
□ Lecture 6: Contemporary Pain Management in Companion Animals (0.5 hrs) …………………………………………….
□ Lecture 7: Sedation, Anesthesia and Behavior Management (0.5 hrs)……………………………………………………..
$10
$10
$50
$10
$10
$20
$20
□ Lecture 8: Parasites and Antiparasitic Therapy (2.5 hrs)……………………………………………………………………..
□ Lecture 9: Dermatology, Topical Therapies and Related Endocrine Disorders (1.25 hrs)………………………………..
□ Lecture 10: Antibiotic Therapy in Companion Animals (0.5 hrs)……………………………………………………………..
□ Lecture 11: Veterinary Pharmacy Law: Regulatory Update (0.5 hrs)………………………………………………………
$100
$50
$20
$20
□ Lecture Series (All 11 Lectures (8.0 hrs)……………………………………………………………………………………...
$300
Name: __________________________________________________________________________________________________
Telephone No. ___________________________________________________
Email address _____________________________________________________________________________________________
*An email address is required to receive confirmation materials. You will receive emails from ceadmin@pharmacy.wisc.edu.
Address _________________________________________________________________________________________________
City, State Zip _____________________________________________________________________________________________
Three ways to register:
1.
Mail this registration form with a check (payable in US funds) to the address below.
2.
By phone at (608) 262-3132 or toll free at (877) 947-4255 with a credit card.
3.
Fax the registration form to (608) 262-2431 with credit card information.
Mail, in the full amount, a check made payable to University of Wisconsin.
UW-Madison School of Pharmacy
Division of Pharmacy Professional Development
777 Highland Avenue
Madison, WI 53705
For course information call:
Ruth Bruskiewitz at (608) 265-8249
ruth.bruskiewitz@wisc.edu
Credit card information (MasterCard, Visa, Discover, and American Express)
Cardholder’s Name
____________________________________________________________
Card Number __________________________________________________________________
Expiration Date ______________________________
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