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Kentucky Chapter American Academy of Pediatrics

Dedicated to the health and well-being of infants, children, adolescents and young adults.

Register for the 2023 Annual Meeting

SAVE THE DATE! August 18-19, 2023

Plan to join us at Sawyer Hayes Community Center, in the E. P. Tom Sawyer State Park, Louisville, KY

KY AAP 2023 Annual Meeting Registration, Office Based Pediatrics

Name*
First Last
Title*
AAP ID#
DOB (MM/DD/YYYY)*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
County*
Email*
Phone*
I will attend: (check EVERY session you will attend)*
- Friday Lunch & Learn
- Friday General Session
- Saturday General Session
Member Category**
- Chapter Affiliate Member, Good Standing
- Associate Member, Good Standing (Pediatric Dentists, Family Physicians)
- Resident Member, Good Standing
- Allied Health Professionals, Good Standing (Licensed Pediatric Nurse Practitioner, Physician Assistant, Other)
- Non-Member, Registration Fee - $150 (After August 1, $175)
By checking the box below, I acknowledge the following: Participant confirms they are (1) vaccinated for COVID-19, meaning Participant shall have completed all the dosing requirements of a specific vaccine regimen more than two weeks prior to Participant's arrival, OR (2) Participant shall have received a negative COVID-19 test result not more than three (3) days prior to Participants arrival at Sawyer Hayes Community Center.*
- Participant Confirmation
Board certified pediatricians are eligible to receive American Board of Pediatrics Maintenance of Certification (MOC) credit for this educational program. If you are board certified, would you like to receive ABP-MOC credit?*
- Yes
- No
- NA
ABP ID Required for ABP-MOC credit.*
I grant KY AAP/AAP permission to share my participation information and completion data with ABP and ACCME via the Program and Activity Reporting System (PARS) housed on ACCME's website. I agree that selecting "YES" is the legal and valid equivalent of my manual/handwritten or electronic signature on this document.*
- Yes
- No

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