1. Presented April 22-23, 2016 Presented by: American College of Cardiovascular Nurses, American Board of Cardiovascular Medicine, and Clearlake Regional Medical Center Alice Friedrich, ANP, MS, BSN, RN, CVRN-BC Level II, MACCN - 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. Alice received rave reviews at all of her events and is one of the most entertaining speakers you could ever hope to spend the day with. Spread the work among your colleagues and join us for a highly interactive course. Clearlake Regional Medical Center is taking the lead in the Houston, TX area by hosting a Clinical Cardiovascular Nursing Course and CVRN Board Certification Opportunity for their Cardiac Nurses, Nurse Practitioners, and those throughout the region at other Hospitals and Clinics who wish to take part in this Professional Development event. This Clinical Cardiovascular Nursing Course was designed to meet the Professional Development and Board Certification needs of 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. Elevating the Standard of Cardiac Care on a Global Scale

2. Course Outline: Friday April 22, 2016 7:00-7:55am - Course & Exam Registration 8-9:30am – Bedside Assessment 9:40-11:45am – EKG Essentials 11:45am – Lunch on your own 12:45-2:00pm - ACS 2:10-3:30pm - Hypertension 3:30-4:45pm – Heart Failure Course/Exam Outline: Saturday April 23, 2016 7:30-7:55am - Course & Exam Registration 8-9:30am - Cardiomyopathy 9:40-11:15am – Interventional Cardiology 11:20-12:00pm - Pacemakers 2:00-5:00pm – CVRN Board Certification Exams Registration Fees and Instructions for the Cardiovascular Nursing Review Course and/or Certification Exams: 1) Clearlake Regional Medical Center or other HCA Healthcare Staff Fees: $120 Course Only; and an additional $220 for the CVRN I Exam 2) All non-Clearlake or HCA Healthcare Staff Fees: $180 Course Only; and an additional $295 for CVRN I Exam A Pre-Registration fee is required for only the Course which must be paid by April 11th to reserve your seat. Any registrations received after this date will be assessed a $20 late fee and will be considered a walk-in registrant. Contact Hours: This course is approved for 7.0 contact hours for 4/22/16 and an additional 4.0 hours for 4/23/16 by the Florida Board of Nursing Provider Number 50-14076. Course Location: Clearlake Regional Medical Center Questions about the Course and Exams Call 352-293-3131 (9am-4pm M-F) or email jcooper@accn.netjcooper@accn.net Terms and Methods of Payment: 1) Pay Online with a credit card under conferences then to Cardiac Nurses at www.abcmcertification.comwww.abcmcertification.com. 2) To Pay by check or money order, make payable to ABCM (may combine Course and Exam fees in one, or separate checks) and mail along with the Registration Form on the next page to: ABCM, P.O. Box 3219, Spring Hill, FL 34611. 3) Do not mail your Course Registration fee after April 7 th to assure safe arrival by April 11 th If you register later than the April 11 th, please email us of your intent to attend the Course so that a course syllabus will be available for you. Send emails to: jcooper@accn.net 4) If you are undecided about the Exam, you may wait to pay for it onsite with cash or check. jcooper@accn.net 5) Please fill out the application on the next page and email it to us when you make your payment, or mail it with your check in the mail.

3. Register for the Cardiovascular Nursing Review Course and/or the CVRN-BC Exam: Scheduled April 22-23, 2016 at Clearlake Regional Medical Center Please do not leave any questions un-answered, or your registration will not be complete. Print clearly in your best handwriting.  I will attend the Cardiovascular Nursing Review Course  I will sit for my CVRN Level I Board Certification Exam at the completion of the Course  I am undecided about taking the CVRN Level I Board Certification Exam and will let you know onsite at the Course. 1. First name: ______________________Middle initial: _____ Last name: ____________________________ 2. Degree(s) Held: _______________________________________________________________ 3. Professional certifications held: __________________________ 4. Nursing or other Professional License Number & State Issued: _____________________________ 5.  Male  Female 6. Home address: ____________________________ City: __________________ State:_________ Zip: ________ 7. Home email:___________________________________ 8. Work email: ___________________________________ 9. Home phone: ______________________ 10. Supervisor’s Name: ______________________________________ 11. Name of Employer: ______________________________________ 12. Phone number of Employer: ________________________________ 13. What area of cardiology do you work in? ______________________ 14. How long have you worked in this area? ________________ 15. What other areas of cardiology do you have experience in? ____________________________________________ 16. How many hours per week do you work in cardiology? ________ 17. Have you had formal training in cardiology? __________ 18. If so, what specialty degree or certification do you hold in cardiology? ___________________________________ 19. Does your hospital have an in-house training program for cardiovascular critical care and telemetry nurses? _______ 20. Does your hospital have an in-house training program for cardiac monitor and EKG Techs? ____________ 21. Is your hospital a Magnet facility or are they seeking Magnet status? ______