INFORMATION REQUEST FORM

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1 Page 1 of 2 INFORMATION REQUEST FORM INFORMATION FOR ONLINE WORKSHOP LISTING Contact for local information NAME: PHONE: Laura Wortman-Haimes (317) (317) work Laura.wortman-haimes@franciscanalliance.org Workshop venue address required with: building name full street address with city, zip/postal room name/number floor number Franciscan Health 8111 S. Emerson Avenue (Auditorium A,B,C classroom located in basement of ), IN Local details required: Closest subway/bus/train stations nearby all-day parking + approx. cost see attached brochure for nearby restaurant and hotel options if venue on a larger campus specific instructions to find/access venue Nearest bus station: Greyhound Bus Station 350 S Illinois St, IN Main phone: (317) Customer Service: (317) Free parking available on campus venue Main entrance of is in Zone 1. Door entrance #12. Take elevators behind the information desk to basement floor and turn left off elevators then follow signs to the auditorium for venue/ classroom (Campus map has been attached) INFORMATION FOR ADMINISTRATION Recommended 3+ or 4-star hotels in a safe and convenient location to the workshop venue Hilton Garden Inn, South/ Greenwood Address: 5255 Noggle Way,, IN Phone:(317) (less than 1 mile from workshop venue) Or Holiday Inn Express & Suites Greenwood Address: 1180 Wilson Drive, Greenwood, IN Phone:(317) (~ 1 mile from seminar venue) Listing of hotel accommodations has been attached to this form Revised Feb 2017

2 Page 2 of 2 Suggested ground transportation arrangements for our instructor between the airport, hotel and workshop venue. If you have any recommendations or can help with local transportation, please let us know. Rental car or taxi cab from International Airport to get to/ from hotel and to/ from workshop AIRPORT >HOTEL: HOTEL>WORKSHOP>HOTEL: HOTEL OR WORKSHOP>AIRPORT: Ship to address for workshop materials shipment International Airport address: 7800 Col. H. Weir Cook memorial Drive,, IN PH: (317) Airport is ~20 miles from venue and hotels listed above Rental car Rental car Venue (circle) or full mailing address (no P.O. Boxes) Franciscan Health Ortho/ Neuro Service Line Administration 6 Tower 8111 S. Emerson Avenue, IN Contact (cell or home #): This is for your instructor should they need assistance from a local outside of business hours. NAME: Laura Wortman-Haimes PHONE: (317) Revised Feb 2017

3 8111 S. Emerson Ave.,, IN I (317) FranciscanHealth.org Campus LEGEND 5230 A 5330 Stop 11 Road Ambulatory Entry Emerson Avenue Valet 6 Valet Drop Off 7 Medical Office Zone 3 10 Interstate 65 for Women & Children Heart Cancer Cancer 4 Cancer 5 Zone 2 Zone 1 2 Car Seat Safety Inspection Women for & Women Children s & Children Heart Hospice House 8414 Franciscan Lane Franciscan Lane Medical Office Parking Entrance/ Door Number Walking Path The walking path is 1.2 miles total Shuttle service: Monday through Friday, 6 a.m. to 8 p.m. Call for pick up: (317) Complimentary valet parking is available at Entrance 6 from 7 a.m. to 6 p.m. Monday through Friday. Rev. 01/2017

4 Clarks Creek Rd S East St Additional hotels offering discount These hotels also honor discounts for patients and their families. Prices are subject to availability. Please note that the does not provide shuttle service for these hotels. Holiday Inn Express Southeast $85/Night 4 miles 5302 Victory Drive north, IN 46203, (317) La Quinta Inn South $52/Night 4 miles 5120 Victory Drive north, IN 46203, (317) Holiday Inn Express South $79/Night 7 miles 5151 S. East St. northwest, IN 46227, (317) Free hotel shuttle to. Call for details. The hotels below are conveniently located near Franciscan Health Mooresville, 1201 Hadley Road. Mooresville HOTEL & RESTAURANT GUIDE for Southeastern Marion County A resource for patients, families and employees of Franciscan Health La Quinta Inn and Suites $79/Night 7 miles 2251 Manchester Road north Plainfield, IN 46168, (317) Comfort Inn $79/Night 7 miles 6107 Cambridge Way north Plainfield, IN 46168, (317) Country Inn and Suites Airport South $81-101/ 8.5 miles 5630 Flight School Dr. Night northeast, IN 46221, (317) Perry Rd 465 Holiday Inn Express South La Quinta Inn South 465 Kentucky Ave Country Inn and Suites Airport South 267 Cambridge Way Comfort Inn Victory Dr E County Rd 6003 La Quinta Inn Suites Flight School Dr Mooresville Rd E Thompson Rd Holiday Inn Express South FranciscanHealth.org Sept. 2016

5 S Sherman Dr Arlington Ave and restaurant guide Local hotels This is a list of hotels that have offered to provide a discount for families of Franciscan Health patients. Ask for the Franciscan Health room rate when booking. Comfort Suites $79/Night 1.5 miles 4125 Kildeer Drive north, IN 46237, (317) Baymont Inn & Suites $64/Night 1.5 miles 4402 East Creek View Drive north, IN 46237, (317) Hampton Inn $97/Night 1.5 miles 7045 McFarland Blvd. north, IN 46237, (317) Courtyard by Marriott $96/Night 1.5 miles 4650 Southport Crossing Drive north, IN 46237, (317) Fairfield Inn (Marriott) $89/Night 1.5 miles 4504 Southport Crossing Drive north, IN 46237, (317) Best Western 15% off 1.5 miles 4450 Southport Crossing Drive Regular Rate north, IN 46237, (317) Hilton Garden Inn $107/Night 1 mile 5255 Noggle Way south, IN 46237, (317) Holiday Inn Express 10% off 1.5 miles 1180 Wilson Drive Corporate Business Rate south Greenwood, IN 46143, (317) Value Place - Greenwood $ single/ 1.5 miles 1009 Greenwood Springs Drive Week south Geeenwood, IN 46143, (317) Candlewood Suites Greenwood ($ double/week) $89/Night 2.5 miles 1190 N. Graham Road (Decreases with 6+ south consecutive nights) Greenwood, IN 46143, (317) Shuttle service Franciscan Health offers free shuttle service between these hotels and the. Hours: Monday through Friday, 6 a.m. to 8 p.m. Call for pick up: (317) Local restaurants A Arby s Chick-Fil-A El Puerto Mexican Jersey Mike s Subs Jimmy John s LongHorn Steakhouse McDonald s Noble Roman s O Charley s Panda Express Panera Penn Station Qdoba Mexican Grill Southport Bar & Grill Uno Chicago Grill B Bob Evans Burger King Carrabba s Italian Grill Cheeseburger in Paradise Cracker Barrel KFC Scotty s Stacked Pickle Starbucks Steak n Shake Texas Road House Waffle House Wendy s C B. Barton s Pub Chick-A-Boom Dianna s Diner Ella s Frozen Yogurt & More Greek s Pizzeria Mexico City Grill Ritter s Frozen Custard Sushi Club The Tailgate Bar & Grill D Aab India Restaurant Brozzini Pizzeria Buffalo Wild Wings Cheddar s El Meson Fireside Brewhouse Lindo Mexico Pasquale s Pizza Popeye s That Place Bar and Grill Tokyo Buffet Zaxby s E Arby s Bob Evans China Wok Denny s JB s Express Main Street Grill McDonald s Mumbai Grill Oaken Barrel Brewery Puerto Vallarta Starbucks Waffle House White Castle 31 S Keystone E Southport Rd McFarland Rd E Stop 11 Rd Madison Ave Madison Ave PARK MALL Comfort Suites County Line Rd 65 Gray Rd B Hampton Inn Best Western Baymont Inn & Suites C MUNICIPAL AIRPORT E A Courtyard Hilton Garden Inn D Holiday Inn Express Value Place McFarland Blvd 65 E Edgewood Ave Shelbyville Rd Shelbyville Rd Franciscan Health 8111 S. Emerson Ave., Education and Support Services 421 N. Emerson Ave., Greenwood Graham Rd County Line Rd Candlewood Suites Five Points Rd E Main St E Main St E Main St Co Rd 300 E E Southport Rd E Stop 11 Rd N W E S