Save $150 Register by March 3, 2017 See page 2 for details.

Save $150 Register by March 3, 2017 See page 2 for details. 2017 Workshop on Perinatal Practice Strategies Scottsdale, Arizona I March 31 April 2, 2017 DoubleTree Resort by Hilton Paradise Valley Scottsdale Sponsored by the American Academy of Pediatrics (AAP) and the AAP Section on Neonatal-Perinatal Medicine. The Best Pediatric CME/CPD* For The Best Pediatric Care The Self-Assessment portion of this course is approved through the AAP MOC Portfolio Program for 10 points by the American Board of Pediatrics for MOC Part 2. Earn a Maximum of 19.50 AMA PRA Category 1 Credits TM *Continuing Professional Development Be Sure to Attend the Neonatal/Perinatal Coding Seminar March 31, 2017 REGISTER ONLINE Call toll-free 866/843-2271

Workshop on Perinatal Practice Strategies PURPOSE AND OBJECTIVES The Workshop on Perinatal Practice Strategies seeks to: Empower leadership Provide a forum for networking Guide change Encourage quality Promote advocacy YOU SHOULD ATTEND THE WORKSHOP IF YOU ARE A(N): Neonatologist, medical director, program director, or division chief Neonatal-perinatal medicine trainee Advanced practitioner Pediatric professional who cares for the fetus and newborn BY PARTICIPATING IN THIS LIVE CME ACTIVITY, YOU WILL BE BETTER ABLE TO: Demonstrate effective leadership skills such as effectively leading change, resolving conflict and motivating others in his/her practice setting to optimize team performance Create a professional network to enhance career development Recognize strategies based on Evidence Based Medicine principles for interpreting and integrating published research for application in making changes in clinical practice Explain basic quality improvement methodologies, identify opportunities for improvement, and apply evidence-based change CONTINUING MEDICAL EDUCATION CREDIT The American Academy of Pediatrics (AAP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The AAP designates this live activity for a maximum of 19.50 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity is acceptable for a maximum of 19.50 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the AAP. The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit from organizations accredited by ACCME. Physician assistants may receive a maximum of 19.50 hours of Category 1 credit for completing this program. This program is accredited for 19.50 NAPNAP CE contact hours; pharmacology (Rx), psychopharmacology, and controlled substance contact hours to be determined per the National Association of Pediatric Nurse Practitioners (NAPNAP) Continuing Education Guidelines. This live session has the prior approval of the American Academy of Professional Coders (AAPC) for 6.5 continuing education hours (CEUs). Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor. SAVE $150 WITH EARLY BIRD RATES! Register by March 3, 2017. REGISTRATION Using your Visa, MasterCard, American Express, or Discover, you can register online at, or call toll-free 866/843-2271. Outside the United States and Canada, call 847/434-4000, option 3. Please have your credit card and concurrent session selections ready prior to calling. If your membership status has changed or lapsed, the registration staff will charge the appropriate fees accordingly. Lodging and meals, other than specified, are not included in the registration fee. Educational sessions, food, and beverages provided during the course are intended for registered attendees only. On-site registrants are welcome if space is available. Availability of course materials cannot be guaranteed for these registrants, however, until after the course. REGISTRANT TYPE/FEES (U.S. Currency) Fees subject to change without notice. Register by March 3, 2017 for Early Bird Rates Early Bird Full Rates Rates Section on Neonatal/Perinatal Medicine Members... $590... $740 AAP Fellows/Candidate Members / International Members (Section Non-Members)... $620... $770 AAP Resident Members/ Post-Residency Training Members... $465... $465 Nonmember Physicians... $775... $925 Nonmember Residents... $705... $705 Allied Health Professionals (Includes Nurse Practitioners & Physician Assistants)... $530... $680 Optional Coding Seminar... $275... $325 2

Special Features FEATURED SPEAKERS L. Joseph Butterfield Lecture George Little, MD, FAAP Dr. George Little is a national and international leader in Neonatal-Perinatal Medicine and Health Care Policy. His career has been notable for service and collaboration with many prominent professional, educational and regulatory organizations, including the Institute of Medicine, NICHD, NPIC, Maternal Child Health Bureau, Joint Commission on Hospital Accreditation, March of Dimes and Harvard School of Public Health. He authored the original seminal document Toward Improving the Outcome of Pregnancy (TIOP) in 1976 and chaired the committee for TIOP II in 1993. Dr. Little has been a service leader for the AAP, including the second Chair of the Perinatal Section and an original member of the Executive Committee. He has been Chair of the Committee on Fetus and Newborn, Associate Editor and Editor of the inaugural and second edition, respectively, of the Guidelines for Perinatal Care. Before neonatal fellowship, he served in the Peace Corps in Africa, which initiated his commitment to international health, and has continued working to improve health care delivery throughout the world, most recently taking leadership in the Helping Babies Breathe program. In 2016, he received the Section s highest recognition as the Apgar Awardee for a career exemplifying the best of the profession. Recognition in 2010, 2011 and Patients Choice Award for 2008, 2009, 2010, 2011, and 2012 from Vitals.com. She is featured with her husband, Bill Klein, on TLC s docu-drama, The Little Couple, which follows her personal and professional life. SPECIAL CODING SEMINAR This seminar is designed to instruct neonatologists and nonphysician coding professionals about CPT codes and how they are used in daily practice. Application of codes to various patient conditions and situations will be explored using audience response system (ARS) technology. Discussion will include recommendations from the audience on the needs and limitations of the current codes. Please indicate on your registration form if you would like to participate in this optional educational opportunity. Please join Drs. Ed Liechty and David Kanter from the Perinatal Section Coding Committee for an extension of the special coding seminar after lunch on Friday afternoon. This discussion will be exclusively devoted to issues and concerns relevant to your practice. Prior to the course, registrants will be asked to provide topics and/or cases for discussion. The extended coding session (S02) is only open to those registered and attending the Special Coding Seminar (S01). Acknowledgments The AAP gratefully acknowledges support for the 2017 Workshop on Perinatal Practice Strategies in the form of an educational grant from Mead Johnson Nutrition. The AAP gratefully acknowledges support for the Welcome Reception from Abbott Nutrition. The AAP gratefully acknowledges support for Saturday s luncheon from Mead Johnson Nutrition. Jennifer Arnold, MD, MSc, FAAP Jennifer Arnold, MD, MSc, FAAP completed pediatric residency, perinatal-neonatal fellowship and obtained a Master s of Science in Medical Education from the University of Pittsburgh. She is currently an attending neonatologist at Baylor College of Medicine and Medical Director of the Simulation Center at Texas Children s Hospital. She was a NIH postdoctoral scholar at the University of Pittsburgh School of Medicine s Safar Center for Resuscitative Medicine from July 2006-July 2007. Dr. Arnold has spoken both nationally and internationally on healthcare simulation education and motivational talks on overcoming obstacles. She has received numerous awards including the Ray E. Helfer Award for innovation in medical education from the Academic Pediatric Association, Compassionate Doctor Save the Date! April 13-15, 2018 2018 Workshop on Perinatal Practice Strategies DoubleTree Resort by Hilton Paradise Valley Scottsdale 3

Schedule Friday, March 31, 2017 S01 Coding Seminar (optional) Additional Registration Fee: See Page 2 for rates 7:00-8:00am AAP Registration/Continental Breakfast for Coding Seminar Participants 7:30-10:00am 10:00-10:15am 10:15am-12:15pm 12:15pm 1:00-3:00pm Coding Seminar Stephen A. Pearlman, MD, MSHQS, FAAP Richard A. Molteni, MD, FAAP Section on Neonatal-Perinatal Medicine Coding Trainers Committee This 4 1/2 hour session will update the audience on changes in neonatal coding practices, using didactic presentations and clinical scenarios. There will be time for questions and discussion with audience participation. Break Coding Seminar (continued) Boxed Lunch for Coding Seminar Participants S02 Extended Coding Seminar for Coding and Billing Professionals* (Open only to participants registered for the Coding Seminar) Please join Drs. Ed Liechty and David Kanter from the Section on Neonatal-Perinatal Medicine Coding Committee Trainers immediately after lunch for an afternoon discussion exclusively devoted to issues and concerns relevant to your practices. *Please note: These sessions are not designated for CME credit. WORKSHOP EDUCATIONAL SESSIONS 1:00-1:20pm 1:20-1:40pm 1:40-2:40pm 2:40-3:40pm 3:40-4:00pm 4:00-4:45pm 4:45-5:30pm 5:30-5:45pm 5:45-6:15pm 5:45pm Welcome/Section & TECaN Update* Howard Kilbride, MD, FAAP, Course Director John Zupancic, MD, ScD, FAAP, SNPM Chair Survey of Neonatologists Knowledge, Opinions, & Attitudes (ARS) DeWayne M. Pursley, MD, MPH, FAAP L. Joseph Butterfield Lecture National and Global Perinatal Practice: Is There Reason to be Optimistic? George Little, MD, FAAP Joe Butterfield was an expert in coordinating the expertise and energies of his colleagues and predecessors while applying his own leadership skills to create new and effective strategies and solutions. His leadership resulted in the implementation of systems for health care education and health care delivery that saved many lives and improved the well-being of millions. The neonatal intensive care unit involves the efforts of a broad, multidisciplinary team of people. The 19th offering of this lecture will provide a history of the evolution of perinatal practice nationally and internationally, with emphasis on cost effective interventions which have improved neonatal survival across the globe. The Butterfield Lecture is supported by an endowment from Abbott Nutrition. Think Big: A Model for Overcoming Obstacles Jennifer Arnold, MD, MSc, FAAP Break/Visit the Exhibits Advocacy for the Newborn in Washington: AAP Update Mark Del Monte, JD Red Blood Cell Transfusion, Anemia & Necrotizing Enterocolitis: Are We Just Chasing Our Tails/Tales? Cassandra D. Josephson, MD How Do We Apply New Evidence to Practice? Roger F. Soll, MD, FAAP Question-and-Answer Session Adjourn for the Day 6:15-7:15pm Welcome Reception: Supported by Abbott Nutrition Maximum CME Credits for Coding Seminar: 4.50 Maximum CME Credits for Friday s Workshop Educational Sessions: 4.25 Maximum CME Credits for Friday: 8.75 4

Schedule Saturday, April 1, 2017 6:30am-4:30pm 6:30-8:00am 7:00-8:00am 8:00-8:15am 8:15-9:15am 9:15-9:30am AAP Registration Desk Open Continental Breakfast/Visit the Exhibits Staffing and Workload Assessments: What Does a Neonatal FTE Mean? Gautham Suresh, MD, DM, MS, FAAP Break/Visit the Exhibits CONCURRENT SESSIONS (E) Early Career Focus; (C) Clinical Focus; (M) Management Focus A1 A2 A3 A4 A5 Count Every Baby (C,E) (Will Repeat as C1) George Little, MD, FAAP David C. Goodman, MD, MS, FAAP Can We Talk? - Safe Communication in the NICU (C, M) Stephen A. Pearlman, MD, MSHQS, FAAP Parental Engagement in the NICU: What Does it Mean? (C,M) Kristin C. Voos, MD Regulatory Patient Safety and Quality Indicator Essentials for Neonatologists and NICU Medical Directors (M) Richard A. Molteni, MD, FAAP Weighty Conversations: Redirection of Care Goals (C,E) (Will Repeat as C5) Brian S. Carter, MD, FAAP Break/Visit the Exhibits 9:30-10:30am 10:30-11:00am CONCURRENT SESSIONS (E) Early Career Focus; (C) Clinical Focus; (M) Management Focus B6 B7 B8 B9 B10 Advocacy Strategies for the Busy Neonatologist (C,E) Mark Del Monte, JD Neonatal Transfusion Medicine: 5 Major Unanswered Research Questions for the 21st Century (C) (Will Repeat as C7) Cassandra Josephson, MD Quality Measures & Benchmarking: How To Use Your Data? (M) Roger F. Soll, MD, FAAP Early Screening and Identification of Candidates for Neonatal Therapeutic Hypothermia (C,M) Thomas K. Shimotake, MD, FAAP Parental Engagement in the NICU: How Can We Do It? (C,M) Kristin C. Voos, MD Break/Visit the Exhibits 11:00am-12:00pm CONCURRENT SESSIONS (E) Early Career Focus; (C) Clinical Focus; (M) Management Focus C1 C5 C7 C11 C12 Count Every Baby (C,E) (Repeated from A1) George Little, MD, FAAP David C. Goodman, MD, MS, FAAP Weighty Conversations: Redirection of Care Goals (C,E) (Repeated from A5) Brian S. Carter, MD, FAAP Neonatal Transfusion Medicine: 5 Major Unanswered Research Questions for the 21st Century (C) (Repeated from B7) Cassandra Josephson, MD Disruptive Behavior and Professionalism in Neonatology (M) Gautham Suresh, MD, DM, MS, FAAP Revenue Cycle Management: Financial Oversight for the Neonatologist (M) Scott Duncan, MD, MHA, FAAP 12:00-1:00pm Lunch: Supported by Mead Johnson Nutrition 5

Schedule 1:00-4:00pm D13 D14 4:00pm HALF-DAY SEMINARS (OPTIONAL) How to use Simulation to Improve Crisis Resource Management (CRM) in Your Unit? Jennifer Arnold, MD, MSc, FAAP Quality Improvement/Preparing Your Project for MOC Part 4 Roger F. Soll, MD, FAAP Gautham Suresh, MD, DM, MS, FAAP Adjourn for the Day Maximum CME Credits for Saturday (without attendance at OPTIONAL half-day seminars): 4.00 Maximum CME Credits for Saturday (with attendance at OPTIONAL half-day seminars): 7.00 Sunday, April 2, 2017 8:00-9:00am 9:00-10:00am 10:00-10:15am 10:15-10:45am 10:45-11:15am 11:15-11:35am Committee on Fetus and Newborn Report: Disaster Preparedness Statement and Early Onset Sepsis Statement Kristi L. Watterberg, MD, FAAP Karen Puopolo, MD, PhD, FAAP Wanda Barfield, MD, MPH, FAAP Burnout and Psychological Resilience in the NICU Gautham Suresh, MD, DM, MS, FAAP Break/Visit the Exhibits Neonatal Palliative Care: Continuing Challenges Brian S. Carter, MD, FAAP The Neuro NICU: Ten Years in Review Thomas K. Shimotake, MD, FAAP Question-and-Answer Session 7:00am-12:00pm 7:00-8:00am AAP Registration Desk Open Continental Breakfast/Visit the Exhibits 11:35-11:55am Survey of Neonatologists Knowledge, Opinions, & Attitudes (ARS) DeWayne M. Pursley, MD, MPH, FAAP 7:00-7:30am NICU Verification Project: An Update* Ann R. Stark, MD, FAAP 11:55am-12:00pm Closing Remarks Howard Kilbride, MD, FAAP, Course Director *Please note: These sessions are not designated for CME credit. 12:00pm Course Adjourns Maximum CME Credits for Sunday: 3.75 Maximum AMA PRA Category 1 Credits for Workshop: 19.50 6

Planning Group and Faculty SCHEDULE AND FACULTY Because we are always striving to improve the quality of your educational experience, schedules are subject to change. The AAP may substitute faculty with comparable expertise on rare occasions necessitated by illness or scheduling conflicts. Please visit for schedule, faculty, and session updates. DISCLOSURE OF FINANCIAL RELATIONSHIPS AND RESOLUTION OF CONFLICTS OF INTEREST The AAP Policy on Disclosure of Financial Relationships and Resolution of Conflicts of Interest is designed to ensure quality, objective, balanced, and scientifically rigorous AAP CME activities. All individuals in a position to influence and/or control the content of AAP CME activities are required to disclose to the AAP and subsequently to learners that they either have no relevant financial relationships or any financial relationships with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in CME activities. All potential conflicts of interest are identified and resolved prior to an individual s confirmation of service at an AAP CME activity. Beyond disclosure of financial relationships, AAP CME faculty are required to disclose to the AAP and to learners when they plan to discuss or demonstrate pharmaceuticals and/or medical devices and/ or medical or surgical procedures that involve off-label use of a device or pharmaceutical. The AAP is committed to providing learners with commercially unbiased CME activities. The content of this CME activity does not necessarily reflect the views or policies of the AAP. FACULTY Jennifer Arnold, MD, MSc, FAAP Houston, Texas Brian S. Carter, MD, FAAP Kansas City, Missouri Mark Del Monte, JD Washington, DC Scott Duncan, MD, MHA, FAAP* Louisville, Kentucky David C. Goodman, MD, MS, FAAP Lebanon, New Hampshire Cassandra Josephson, MD Atlanta, Georgia George Little, MD, FAAP Lebanon, New Hampshire Richard A. Molteni, MD, FAAP* Philipsburg, Montana Stephen A. Pearlman, MD, MSHQS, FAAP* Philadelphia, Pennsylvania DeWayne M. Pursley, MD, MPH, FAAP Boston, Massachusetts Thomas K. Shimotake, MD, FAAP San Francisco, California Roger F. Soll, MD, FAAP Burlington, Vermont Gautham K. Suresh, MD, DM, MS, FAAP Houston, Texas Kristin C. Voos, MD Kansas City, Missouri Kristi L. Watterberg, MD, FAAP Albuquerque, New Mexico *Also on SONPM Coding Trainers Committee CONTRIBUTING FACULTY Wanda Barfield, MD, MPH, FAAP Atlanta, Georgia Karen Puopolo, MD, PhD, FAAP Philadelphia, Pennsylvania Ann R. Stark, MD, FAAP Nashville, Tennessee John A. F. Zupancic, MD, ScD, FAAP Boston, Massachusetts SONPM CODING TRAINERS COMMITTEE Michael Gomez, MD, FAAP Albuquerque, New Mexico David M. Kanter, MD, FAAP Palm Beach Gardens, Florida Angela D. Kelley, CPC Galveston, Texas Edward A. Liechty, MD, FAAP Indianapolis, Indiana Sheri Nemerofsky, MD, FAAP Scarsdale, New York Ted Rosenkrantz, MD, FAAP Farmington, Connecticut Stuart Weisberger, MD, FAAP Worcester, Massachusetts 2016 PLANNING GROUP Howard Kilbride, MD, FAAP, Chair Kansas City, Missouri Krithika Lingappan, MD, FAAP Houston, Texas Richard J. Powers, MD, FAAP San Jose, California Meredith Mowitz, MD, FAAP Gainesville, Florida Scott Alan Snyder, MD, FAAP Boise, Idaho Cherrie Dawn Welch, MD, MPH, FAAP Winston-Salem, North Carolina 7

Section Information/Resources The AAP is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical subspecialists committed to the attainment of optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults. For more information, visit www.aap.org. AAP SECTION ON NEONATAL-PERINATAL MEDICINE Founded in 1974, this AAP Section is composed of members who have a special interest in practicing in the fields associated with or related to neonatal-perinatal medicine. The Section was formed for the purpose of improving the care of newborn infants and fetuses, pregnant women and their families by providing an educational forum for the discussion of problems relating to neonatal medicine, pregnancy, and parturition. Membership in the Section is open to Fellows and Resident Members of the AAP and approved National and Section affiliates who are actively involved in the fields associated with or related to neonatal medicine. To join the Section, call 800/433-9016, ext. 5897. INTENSIVE NEONATOLOGY SELF-ASSESSMENT Stay current with the AAP s self-assessment program mapped to neonatal-perinatal medicine content specifications, NeoReviewsPlus. Get the latest critical information from neonatal experts all chosen to help you provide the best care for neonates. 1-YEAR ANNUAL ONLINE ONLY SUBSCRIPTION INCLUDES NeoReviewsPlus Self-Assessment Including 96 case-based questions with detailed explanations of the preferred response, along with a discussion of why other choices were considered incorrect. NeoReviews CME Journal 12 monthly issues of CME peer-reviewed journal articles featuring clinical articles, case scenarios, and timely reviews packed with evidence-based information on the diagnostic and therapeutic management of diseases and delivery of pediatric care. A 1-year annual subscription to NeoReviewsPlus includes 8 questions per month and 20 MOC Part 2 points per year. Subscription term begins January 2017. Order online at shop.aap.org/2017-neoreviewsplus. NeoReviewsPlus is supported for neonatal-perinatal fellows in training through an educational grant from Abbott Nutrition, a division of Abbott Laboratories, Inc. This activity has been approved for AMA PRA Category 1 Credit. 8

Hotel, Travel, and Registration Information HOTEL AND TRAVEL ARRANGEMENTS DoubleTree Resort by Hilton Paradise Valley Scottsdale 5401 North Scottsdale Road Scottsdale, Arizona 85250-7090 www.paradisevalley.doubletree.com Direct Phone Number: 480/947-5400 Toll-free Phone Number: 800/222-8733 Guest Fax Number: 480/946-1524 Special group rates beginning at $225 per night, plus tax, for single or double occupancy, have been negotiated at the DoubleTree Resort by Hilton Paradise Valley Scottsdale. These rates represent substantial savings from published rates. The cutoff date for reservations at the group rate is March 3, 2017. Call the hotel directly to make your reservations and be sure to mention that you are attending the AAP Perinatal Workshop. A limited number of guest rooms have been reserved, and they are assigned based on availability (first-come, first-served). Please be aware that the room block may be filled prior to March 3, 2017; in such a case, neither the group rate nor guest room availability can be guaranteed. The AAP, therefore, recommends that you make your reservations as early as possible. GROUND TRANSPORTATION The DoubleTree Resort by Hilton Paradise Valley is located approximately 12 miles from Phoenix Sky Harbor International Airport. For information on shuttle service, contact SuperShuttle at 800/258-3826 or www.supershuttle.com. Taxi service is also available. CAR RENTAL DISCOUNTS The AAP Travel Office is offering CME course attendees a reduced car rental rate through Hertz and Avis. Please ask your AAP Travel Agent for details. Hertz can be reached directly at 800/654-2240 or www.hertz.com. The AAP discount code is CV01570018. Avis can be reached at 800/331-1600 or www.avis.com. The AAP discount code is A628999. PARKING Complimentary self-parking and valet parking are both available at the hotel. CHILD CARE Please contact the hotel concierge for recommendations regarding child care services. SPECIAL NEEDS The AAP is sensitive to the special needs of its attendees. Please indicate any accommodations on your registration form. Scooter and wheelchair rentals are available by contacting ScootAround, Inc., toll-free at 888/441-7575, by email at info@scootaround.com, through their website at www.scootaround.com, or by fax at 204/478-1172. CANCELLATIONS Cancellations must be received in writing by March 17, 2017 to receive a refund. An administrative charge of $50 will be deducted. ONLINE SYLLABUS The Workshop on Perinatal Practice Strategies is environmentally friendly! The syllabus for the 2017 Workshop will be online only. About one week prior to the workshop, you can expect to receive an email with instructions for accessing the online syllabus. Only registered participants will have access to view and download session handouts, along with other useful information. If you are interested in viewing the contents of the online syllabus while in Scottsdale, we encourage you to bring a laptop computer or tablet and download the handouts prior to arriving at the course. If you prefer to have printed handouts in front of you while at the workshop, we encourage you to print those from the online syllabus ahead of time and bring them with you. There will not be any AAP-provided printer stations at the workshop. Electrical power for laptop and tablet use will not be available for full time use by each course attendee throughout the educational sessions. A limited number of power outlets will be available for brief recharging of computers and tablets during the courses. EARN MOC PART 2 POINTS! Register to attend the 2017 Workshop on Perinatal Practice Strategies Complete the online, pre-course self-assessment by the deadline date Attend the 2017 Workshop on Perinatal Practice Strategies in Scottsdale, Arizona Complete the online, post-course self-assessment with a minimum passing score of 80% by the deadline date The pre- and post-course self-assessments are a bonus to registered course attendees to enhance the learning experience at the live activity and provide 10 ABP MOC Part 2 Points in addition to the CME credit earned by attending the course. Disclaimer: You are not eligible to claim MOC Part 2 credit for this course-related self-assessment, if you have received MOC Part 2 credit for completing the AAP s 2014 NeoReviews Plus Self- Assessment. All approved activities must be completed by the MOC Credit Approval End Date. All deadlines and MOC point values should be confirmed by checking the ABP Activity Catalog within each physician s ABP Portfolio. Consult your ABP portfolio at www.abp.org for details about your specific certification requirements. Note: Please include your email address to ensure that you receive instructions for accessing the MOC pre/post-tests and instructions for accessing the online syllabus. Please contact AAP registration if you do not receive an email approximately one week prior to the course. 9

Registration Form 2017 Workshop on Perinatal Practice Strategies DoubleTree Resort by Hilton Paradise Valley Scottsdale, Arizona March 31-April 2, 2017 Register by March 3, 2017, for Early Bird Rates! REGISTER BY ONE OF THE FOLLOWING OPTIONS: Online at: shop.aap.org /perinatal2017 Call toll-free: 866/843-2271 Mail this form with payment to: American Academy of Pediatrics/Registration P.O. Box 776442 Chicago, Illinois 60677-6442 Fax this form to: 847/228-5059 PLEASE TYPE OR PRINT NAME ADDRESS FIRST LAST (SURNAME) MD, DO, OTHER (SPECIFY) CITY/STATE/PROVINCE ZIP CODE / POSTAL CODE / COUNTRY DAYTIME PHONE CELL NUMBER E-MAIL ADDRESS (REQUIRED TO RECEIVE INSTRUCTIONS FOR ACCESSING ONLINE COURSE INFORMATION) EMERGENCY CONTACT NAME/ PHONE AAP ID# PLEASE INDICATE ANY SPECIAL NEEDS (E.G., BREASTFEEDING ACCOMMODATIONS, DIETARY RESTRICTIONS /ALLERGIES, PHYSICAL DISABILITIES). SO1: CODING SEMINAR Friday, March 31, 2017 7:30am-12:15pm Coding Seminar for the fee of $275/$325. Note: You do not need to register for Perinatal Workshop to attend the Coding Seminar. SO2: Extended Coding Seminar for Coding & Billing Professionals Note: You must register for the Coding Seminar to be able to attend this session. CONCURRENT SESSIONS Saturday, April 1, 2017 Please fill in the code of your first and second choices for all three sessions. First Choice Second Choice 8:15am: 9:30am: 11:00am: OPTIONAL SATURDAY April 1, 2017 Half-Day Seminars These seminars are open to all attendees; however, space is limited and will be on a first-come, first-served basis. D13: How to Use Simulation to Improve Crisis Resource Management (CRM) in Your Unit? D14: Quality Improvement/Preparing your Project for MOC Part 4 REGISTRATION FEES (U.S. Currency) EARLY BIRD FULL RATE AAP Section on Neonatal-Perinatal Medicine Members....$590.... $740 AAP Fellows/Candidate Members/International Members (Section Nonmembers)....$620.... $770 AAP Resident Members/ Post-Residency Training Members....$465.... $465 Nonmember Physicians....$775.... $925 Nonmember Residents....$705.... $705 Allied Health Professionals....$530.... $680 (Includes Nurse Practitioners & Physician Assistants) Optional Coding Seminar....$275.... $325 Your registration will be confirmed. Please contact the AAP Registration Area if you do not receive a confirmation within 14 days. The AAP recommends that you do not make travel or hotel reservations that cannot be changed or cancelled without penalty until you receive your confirmation, as the AAP cannot be responsible for expenses incurred by an individual who is not confirmed and for whom space is not available at this course. Costs incurred, such as airline or hotel penalties, are the responsibility of the individual. The AAP reserves the right to cancel a course due to unforeseen circumstances or to limit enrollments, should attendance exceed capacity. Sign me up for the CME Listserv to receive information on upcoming AAP CME activities. EMAIL ADDRESS PAYMENT INFORMATION Full payment must accompany this form. Please indicate method of payment below: Charge it: CARD NUMBER EXPIRATION DATE PRINT NAME AS IT APPEARS ON CARD Or checks may be made payable to the American Academy of Pediatrics. (United States only) CHECK NUMBER Please do not send currency. AMOUNT

Questionnaire Check one of the following to indicate your practice type: Neonatologist NICU Director Neonatal-Perinatal Program Director Neonatal-Perinatal Division Chief Neonatal-Perinatal Medicine Trainee Nurse Practitioner Physician Assistant Registered Nurse Non-Physician Coding & Billing Professional Other (please specify) How many years have you been in practice (post-fellowship)? 0-7 years (including Trainees) 8-17 years 18-29 years 30+ years Not in practice Have you attended this conference in the past? Yes No How did you hear about this course? Email Direct mail Word of mouth Online (please specify website: ShopAAP.org, aap.org, other) What is your primary objective for attending this course? Earn CME credits Meet neonatal leaders Career/leadership development Other