Diabetes Re-Imagined: Community and Clinical Partnership Registration Form

Welcome to the "Diabetes Re-Imagined" symposium event registration page. This inaugural event, hosted by the Institute for the Advancement of Community Health (IACH), will take place from 12:30 to 6:00pm on November 17th at Yount's Conference Center located on Furman University's Campus. DEADLINE FOR REGISTRATION -12:00PM on WEDNESDAY, OCT. 25th, 2017.

This free event will highlight existing community, clinical and academic partnerships to reduce the impact of diabetes in our communities. The event will also spark dialogue between attendees to create innovative solutions to address critical health needs in our community.

This form will allow you to register as an individual attendee. If multiple individuals from your organization are planning to attend, they will need to register separately. We also invite you to share this invitation with any colleagues that would be interested in attending.

The proposed program agenda is below and subject to minor changes.

SCHEDULE

12:30 - 01:00 Registration

01:00 - 01:30 Welcome & Introduction - "State of Diabetes in the Community"

01:30 - 02:30 Session I - "Community Partnership in Action"

Evolution of Exercise is Medicine Greenville: Exploring partnership to improve population health.
Peter Tilkemeier, MD, Chair Dept. of Med - GHS
Ann Blair Kennedy,LMT, DrPH, Clinical Asst. Prof.- USCSOM Greenville
Scott Baddley, President and CEO - YMCA of Greenville

02:30 - 02:40 Break

02:40 - 03:40 Session II - "Community Dialogue: Finding Innovative Solutions"

Session Moderator: Rick Foster, MD, Senior Advisor, Pop. Health Improvement - SCHA

03:40 - 03:50 Break

03:50 - 04:50 Session III - "Community Partnership in Action"

Diabetes Self-Management: A community based model.
Michelle Parisi, PhD, RDN, Director of Nutrition and Health Extention Prog. - Clemson University
Michelle D. Stancil, RN, BSN, CDE, Mang of Diabetes Mgmt. Program - GHS
Windsor Westbrook Sherrill, PhD, MHA, MBA, Associate VP for Health Research - GHS

04:50 - 05:00 Closing Remarks

05:00 - 06:00 Mixer - Food and Wine provided
Name Name Title First Last Suffix
Name of Organization
Organizational Role
Email
Re-enter Email
Phone Phone - ### - ### ####
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Please provide us with the following information.
In what capacity will you represent your organization at this event?

In what capacity will you represent your organization at this event? Community Worker (Non-profit Employee, Advocate, Organizer, etc.) Clinical Practitioner (Physician, Nurse, Clinical Dietitian, etc.) Academic Researcher Other (Please describe) Other (Please describe)
What experiences are you most interested in gaining from this event? (Check all that apply.)

What experiences are you most interested in gaining from this event? (Check all that apply.) Learning how to identify opportunities for collaboration between clinical, community, and academic partnerships. Learning about innovative practicies to address diabetes and chronic disease in our community. Participating in group discussion around the state of diabetes in our community and create potential solutions. Networking with like minded professionals. Other Other
If you have any questions about this event please contact the IACH Community Action Director, Melissa Fair, at melissa.fair@furman.edu
Brought to you in partnership with the GHS Health Sciences Center.

Diabetes Re-Imagined: Community and Clinical Partnership Registration Form

Diabetes Re-Imagined: Community and Clinical Partnership Registration Form

Please provide us with the following information.

If you have any questions about this event please contact the IACH Community Action Director, Melissa Fair, at melissa.fair@furman.edu

Brought to you in partnership with the GHS Health Sciences Center.