2012 GA Rural Health IT Conference

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Georgia Rural Health IT Registration Form

Thursday, January 26, 2012
Registration: 8:30 - 9:00 am
Session: 9:00 am - 4:00 pm

Hotel Registration - Marriott City Center, Macon, GA
HTH Group Code "hnhhnha"

Cost: $100.00 for 1st person + $75 for each additional

Signed GA-HITREC hospitals receive 1 FREE attendee

Premier HIT conference for rural hospitals with a focus on:

• GA-HITREC (Georgia Health IT Regional Extension Center)
• Georgia Health Information Exchange
• HIPAA and HiTECH
• Support Services for IT Success
• Overcoming the Challenges of meeting Meaningful Use of E H R
• Telehealth
• Integrating Your Provider Community
• Clinical HIT Leadership Essential Elements

CEUs will be offered

Any questions, please contact Sherri Ackerman, (770) 402-3105
____________________________________________________________________________________________

Organization Name:

# of Attendees:

Email:

1st Name:

1st Title:

2nd Name:

2nd Title:

3rd Name:

3rd Title:

4th Name:

4th Title:

Form of Payment:

Check
Credit Card
GA-HITREC Hospital
Business Partner

$100 per attendee + $75 for each additional
Signed GA-HITREC hospitals receive 1 FREE attendee

For Checks please mail to
3280 Cherry Oak Lane
Cumming, GA 30041
RE: GA Rural Health IT Conference

If Credit Card is selected you will redirected to the payment portal after submission

Notes on Registration: