North Shore University Hospital June 21-22, 2014

1. ACCN AMERICAN BOARD OF CARDIOVASCULAR MEDICINE ABCM Est. 1991 Cardiovascular Nursing Prep Course & Board Certification Opportunity This Clinical Cardiovascular Nursing Essentials Course was designed to meet the Professional Development and Board Certification needs of your Cardiac Nurses and Nurse Practitioners working in PCU, Telemetry, Emergency Chest Pain Centers, Cardiovascular Critical Care, Cath Lab, CV Surgery, CV Recovery, Cardiac Rehab, and Private Practice Cardiology Offices and Clinics. If your hospital is seeking or needs to maintain Magnet Status, the Board Certification Exams offered by the American Board of Cardiovascular Medicine are approved by the ANCC for Magnet applications. North Shore University Hospital, Manhasset, NY is taking the lead in New York, by Hosting a Clinical Cardiovascular Nursing Course and CVRN Board Certification Opportunity for their Cardiac Nurses and Nurse Practitioners, and those throughout the region at other Hospitals and Clinics who wish to take part in this Professional Development event. North Shore University Hospital June 21-22, 2014 Presented by:American College of Cardiovascular Nurses &the American Board of Cardiovascular Medicine, and North Shore University Hospital The ABCM has over 6,000 Board Certified Nurses Nationwide! Alice Friedrich, ANP, MS, BSN, RN, CVRN-BC Level II. Alice currently works as a Cardiovascular Nurse Practitioner for the North Shore LIJ Health System in New York.  Alice was among the first Nurse Practitioners to receive CVRN Board Certification Status in 2000. Alice comes to you with a phenomenal amount of Essential Knowledge and Clinical Expertise to assist you in the Diagnosis and Management, and Daily Care of Cardiovascular Patients with a host of Cardiovascular Anomalies. A frequent speaker at ACCN courses on a national level.

2. Register for CVRN Board Certification Exam Complete the Application below (answer all questions), & make Exam Registration fees payable to ABCM and mail to: ABCM, P.O. Box 3219, Spring Hill, FL 34611. Do not mail your Exam application and fee after June 10, 2014, simply bring it to the meeting, and send an RSVP to jenragan@accn.net to reserve your seat in the Exam. Or, go online to www.accn.net to pay for your Exam and or/Course with your credit card under Live Cardiology Courses for this location. Exam Costs: CVRN I Exams: LIJ Healthcare Staff: $250; all others $280 Register for the CVRN Review Course &/or Exam 1. First name: ______________________Middle initial: _____ 2. Last name: ___________________ Degree: _____________3. Professional certifications held: __________________________ 4. Nursing License Number & State Issued: _____________________ 5. q Male q Female 6. Home address: ____________________________ City: __________________ State:_________ Zip: ________ 7. Home email:___________________________________8. Work email: ___________________________________ 9. Home phone: ______________________ 10. Name of employer: __________________________________ 11. Phone number of employer: ______________________________12. What area of cardiology do you work in? _____________________ 13. How long have you worked in this area? _____________________ 14. What other areas of cardiology do you have experience in?____________________________ 15. How many hours per week do you work in cardiology? ________16. Have you had formal training in cardiology? __________ 17. If so, what specialty degree or certification do you hold in cardiology? ___________________________________18. Does your hospital have an in-house training program for critical care and telemetry nurses? ___________19. Is your hospital a Magnet facility or are they seeking Magnet status? ______20. q I will be attending the CVRN Review Course 6/21-22/2014 21. q I will be sitting for the CVRN Board Exams June 22, 2014 22. q I am undecided about the Exams and will tell you on 6/21/2014 June 21, 2014 - Course Outline: 7:00-7:55am Course & Exam Registration 8-9:20am – Acute Coronary Syndromes 9:30-10:50am - Heart Failure 11-12:00pm - Cardiomyopathy 12-1:00pm – Lunch 1-2:00pm - Bedside Assessment of CV Patient 2:10-:4:00pm - EKG Essentials including 4:10-5:00pm - Pacemakers June 22, 2014 - Course Outline: 7:30-7:55am Course & Exam Registration 8-10:00am - Interventional Cardiology 10:15-11:15am - Hypertension 2:00-5:00pm – CVRN Board Certification ExamsRegistration for CVRN Course &/or Exams:LIJ Healthcare System Staff: $50 nonrefundable deposit required to reserve seats, and pay balance of $70 by 6/15/2014. Or you may pay the entire fee of $120 before 6/15/2014. All payments after this date will be assessed a $20 late fee. Non-LIJ Healthcare System Staff: $50 nonrefundable deposit required to reserve seats, and pay balance of $110 by 6/15/2014. Or you may pay the entire fee of $160 before 6/15/2014. All payments after this date will be assessed a $20 late fee. Bring your hospital ID Badge & Nursing License Number.If registering in the mail, make Course and/or Exam registration fees payable to ABCM and mail the registration form along with your check or money order to: P.O. Box 3219, Spring Hill, FL 34611. Do not mail your Course or Exam fees after June 10, 2014; at this late date, you must go online and at least make your payment. All late registrants and walk-ins will be assessed a $20 late fee for the course but not the exam. Course Location: North Shore University Hospital: 300 Community Drive, Manhasset, NY 11030 (Rust Auditorium). Contact Hours:This course is approved for 7.0 contact hours for day one and an additional 4.0 hours for day two, by Florida Board of Nursing provider number 50-14076.