March 19, Dear Exhibitor,

Transcription

1 March 19, 2018 Dear Exhibitor, On behalf of course director, Eric R. Eggenberger, D.O., we hope you will consider a display opportunity at our Mayo Clinic Practical Clinical Case-Oriented Neuro-Ophthalmology course being held on November 15-17, 2018 at The Loews Royal Pacific Resort in Orlando, Florida. We expect around 100 physicians who deal with neuro-ophthalmologic patients especially neurologists, ophthalmologists, optometrists, and neurosurgeons, but also other interested practitioners including internists, family care practitioners, emergency room physicians, and PAs. This course reviews multiple topics in clinical neuro-ophthalmology. The first day consists of didactic lectures by experts in neuro-ophthalmology on various topics including papilledema, seuodapapilledma, diplopia, nystagmus and neuroradiology. On the second day, cases of common neuro-ophthalmologic problems are presented to our panel for discussion of practical approaches to patient evaluation and management. Conditions presented include optic neuritis, neuroretinitis, neuromyelitis optica, ischemic optic neuropathy, Horner syndrome, downbeat nystagmus and myasthenia gravis. The day also includes a session on the clinical and neuro-radiologic correlation of several neuro-ophthalmologic disease processes. The third day starts with case presentations by retina experts attempting to sort out the question of optic nerve or retina? as a cause of visual loss. Display fees are $2,000 for the length of this course. Space is limited and table assignments will be made on a first come, first served basis. Mayo Clinic, an integrated, not-for-profit group practice, is committed to meeting its responsibility as a national medical education resource and is accredited by the Accreditation Council for Continuing Medical Education to provide AMA PRA Category 1 Credit(s) for this course. Our programs provide valuable information on unmet needs to the medical community. We sincerely appreciate your consideration and hope you will take the opportunity to join us for a truly unique educational program. Sincerely, Victoria Clifton Education Specialist Make checks payable to: Mayo Clinic Attn: Lauren Wilbur/18J San Pablo Road Stabile 790N- Education Jacksonville, FL Tax ID:

2 Page 1 of 2 Mayo Clinic School of Continuous Professional Development (MCSCPD) Exhibitor Agreement Activity Title Practical Clinical Case Oriented Neuro Ophthalmology Activity Number 18J06166 Location Loews Royal Pacific Resort, Orlando, Florida Dates November 15 17, 2018 Agreement between: ACCREDITED PROVIDER: Mayo Clinic College of Medicine and Science MCSCPD AND: Company Name (Exhibitor) (as it should appear on printed materials) Exhibit Contact (if different then exhibit Rep.) Name(s) of Representative(s) exhibiting: (Maximum of two representatives allowed per exhibit) Address Telephone Fax The named exhibitor wishes to exhibit at the above named activity for the amount of $2,000 NOTE: There may be additional charges depending on the meeting location (power, internet access, etc.). Please list additional requests here: (please note: additional requests may incur additional fees) TERMS AND CONDITIONS EXHIBITOR agrees to abide by ACCME Standards for Commercial Support as stated at SCS 4.2: Product promotion material or product specific advertisement of any type is prohibited in or during CME activities. The juxtaposition of editorial and advertising material on the same products or subjects must be avoided. Live (staffed exhibits, presentations) or enduring (printed or electronic advertisements) promotional activities must be kept separate from CME. For live, face to face CME, advertisements and promotional materials cannot be displayed or distributed in the educational space immediately before, during or after a CME activity. Providers cannot allow representatives of Commercial Interests to engage in sales or promotional activities while in the space or place of the CME activity. EXHIBITOR may only distribute educational promotional materials at their exhibit space. Distribution of noneducational items (pens, notepads, etc.), pharmaceuticals or product samples is prohibited. All exhibit fees associated with this activity will be given with the full knowledge of the PROVIDER. No additional payments, goods, services or events will be provided to the course director(s), planning committee members, faculty, joint provider, or any other party involved with the activity.

3 Page 2 of 2 Completion of this agreement represents a commitment and EXHIBITOR is obligated to provide full payment of all amounts due under this agreement by the ACTIVITY DATE unless otherwise agreed upon by the PROVIDER. PROVIDER reserves the right to refuse exhibit space to EXHIBITOR in the event of nonpayment or Code of Conduct violation. If this agreement is cancelled by either party forty five (45) days or more in advance of the Activity Date, PROVIDER will refund the Exhibit Fee less a $300 processing fee. If this agreement is cancelled by EXHIBITOR less than forty five (45) days in advance of the Activity Date, the total amount due under this Agreement shall be immediately due and payable to PROVIDER. PROVIDER agrees to provide exhibit space and may acknowledge EXHIBITOR in activity announcements. PROVIDER reserves the right to assign exhibit space or relocate exhibits at its discretion. Note: All exhibitors must be approved by MCSCPD and this agreement is not binding until both parties have signed. MCSCPD maintains the right to refuse any exhibitor. By signing below, I agree to the Terms and Conditions outlined on Page 1 of this Exhibitor Agreement (including ACCME Standards for Commercial Support): The person signing below is authorized to enter into this agreement: Exhibitor Representative Name Signature Date Mayo Clinic Representative Name Signature Date PAYMENT INFORMATION Please indicate your method of payment: PROVIDER Federal Tax ID number is Please remit check payable to: Mayo Clinic Mayo Clinic School of CPD. Please identify name of course on the check stub. Check Make payable to: Mayo Clinic Mayo Clinic School of Continuous Professional Development Attn: Lauren Wilbur, 790N 4500 San Pablo Road Jacksonville, FL Credit Card For payment by credit card, please call the MCSCPD at Do not send credit card information via or fax. Please identify 18J06166 on the check.

4 Practical Clinical Case Oriented Neuro Ophthalmology 2018 Lowes Royal Pacific, Orlando, Florida November 15 17, 2018 Thursday, November 15 th, :00am 7:50am Registration and Continental Breakfast 7:50 8:00 Welcome and Introduction 8:00 8:25 Unexplained Visual Loss ON, Retina, Functional Andy Lee, MD 8:25 8:30 Q&A 8:30 8:55 Retinal Mimics Michael Stewart, MD 8:55 9:00 Q&A 9:00 9:25 Optic Neuropathy Inflammation and Infection John Chen, MD, PhD 9:25 9:30 Q&A 9:30 9:50 Break 9:50 10:15 Optic Nerve Ischemic: NAION, GCA Neil Miller, MD 10:15 10:20 Q&A 10:20 10:45 Optic Nerve: Hereditary, Compress, Toxic Def Tariq Bhatti, MD 10:45 10:50 Q&A 10:50 11:15 Papilledema/Pseudopapilledema/IIH Marie Acierno, MD 11:15 11:20 Q&A 11:20 11:45 Chiasm/Retrochiasm/Fields 11:45 12:00 Q&A 12:00pm 12:30 Lunch 12:30 12:50 OCT/Retinal Imaging John Chen, MD, PhD 12:50 1:00 Q&A 1:00 1:20 Pupil Andy Lee, MD 1:20 1:25 Q&A 1:25 1:45 Nystagmoid 1:45 2:00 Q&A 2:00pm Adjourn Friday, November 16 th, :00am 7:55 Continental Breakfast 7:55 8:00 Welcome 8:00 8:20 EOM Neil Miller, MD 8:20 8:40 CN 8:40 9:00 NMJ Marie Acierno, MD 9:00 9:20 Supranuclear Treatment: Prism, Exercises 9:20 9:35 Christian Guier, OD Program schedule is subject to change without notice.

5 Practical Clinical Case Oriented Neuro Ophthalmology 2018 Lowes Royal Pacific, Orlando, Florida November 15 17, :35 9:50 Break Neuro rads Update/ 9:50 10:10 Daniel Broderick, MD 10:10 10:50 Andy Lee, MD 10:50 11:20 Marie Acierno, MD Retina 11:20 11:50 Faculty 11:50 12:00 Q&A 12:00 12:30 Lunch 12:30 12:50 Tariq Bhatti, MD 12:50 1:10 John Chen, MD, PhD 1:10 1:30 Neil Miller, MD 1:30 1:50 1:50 2:00 Q&A 2:00pm Adjourn 7:15am 8:00 Continental Breakfast 8:00 10:00 and Controversies Faculty 10:00 10:30 Break 10:30 12:00 and Controversies Faculty 12:00pm 12:30 Q&A / Lunch 12:30 2:00 and Controversies 2:00pm Adjourn Saturday, November 17 th, 2018 will include: CN3 MG Horner Pituitary apoplexy Wernicke Large pupil case Sagging eye Retinal mimic Transient diplopia Transient visual loss Transient pupil changes MG first line therapy PTC first line therapy NAION role of comorbidities OSA, PDE5 inhibiters NAION treatment steroids CRAO treatment TED first line treatment GCA diagnostic approach GCA initial Tx Program schedule is subject to change without notice.