REGISTRATION FEES WAYS TO REGISTER Web AnnualMeeting.ascrs.org Email mbraxton@ascrs.org Mail ASCRS ASOA 2017 c/o Convention Data Services 107 Waterhouse Road Bourne, MA 02532 Cancellation/Refund Policy All cancellations and requests for refunds must be in writing and received no later than April 14, 2017. A handling fee of $150.00 will be deducted from each cancelled registration. The membership dues portion of the registration fee is nonre-fundable. NO REFUNDS will be given after April 14, 2017. # Categories Tier 1 12/5/16 2/16/17 Tier 2 2/17/17 4/21/17 Tier 3 After 4/21/17 1 ASCRS Domestic Member* $940 $1,100 $1,260 2 ASCRS International Member* $835 $995 $1,155 3 ASCRS Military/Government $500 $600 $700 4 ASCRS Young Physician $220 $280 $340 5 ASCRS Domestic Resident/ Fellow (Includes Canadians) COMPLIMENTARY 6 International Resident/Fellow $220 $270 $320 7 ASOA Member* $425 $475 $525 8 ASOA Nonmember $600 $650 $700 9 Technicians & Nurses $495 $495 $595 10 Joint ASOA/Technicians & Nurses $650 $700 $750 11 Corporate/Other $1,045 $1,525 $1,995 12 13 Integrated Eyecare Optometrist Physician's Assistant (Nonmember) $495 $595 $695 $525 $625 $725 14 Guest $180 $180 $180 15 Press COMPLIMENTARY 16 Physicians (Domestic & International may attend w/o membership) 17 Military/Government Physicians s (Cornea, Glaucoma, and Refractive) $425 $475 $525 $200 $200 $225 18 Young Physician $220 $280 $320 19 Domestic Resident/Fellow COMPLIMENTARY 20 International Resident/Fellow $220 $270 $320 # 1 2 3 4 5 6 7 8 9 10 11 12 13 Annual Meeting Packages Pricing Tier 1 Tier 2 Tier 3 ASCRS and Cornea, Glaucoma, or Refractive Domestic Physician and International Physician and Military/Government and Young Physician and Domestic Resident/Fellow and Canadian Resident/Fellow and International Resident/Fellow/ Corporate/Other and $1,365 $1,575 $1,785 $1,260 $1,470 $1,680 $695 $795 $945 $440 $560 $640 COMPLIMENTARY COMPLIMENTARY $440 $540 $620 $1,670 $2,150 $2,645 ASOA and Cornea, Glaucoma, or Refractive ASOA Member and Subspecialty Staff ASOA Nonmember and Subspecialty Staff $630 $735 $835 $805 $910 $1,010 Techs and Nurses and Cornea, Glaucoma, or Refractive Techs & Nurses and Joint Techs & Nurses/ASOA and $700 $805 $905 $855 $960 $1,060 Miscellaneous and Cornea, Glaucoma, or Refractive Integrated Eye Care Optometrist and Subspecialty $920 $1,070 $1,220 14 Physician s Assistant $630 $735 $835 21 22 Integrated Eye Care Optometrist Subspecialty Staff (Admin, T&N, Other) $425 $475 $525 $205 $260 $310 23 Corporate/Other $625 $625 $650 * Membership dues must be current through May 31, 2017 and are not included in the registration fee. ASCRS membership must be in good standing for program (excluding s); ASOA program does not require membership. International Resident/Fellow must pay international membership dues. The joint registration category is for those interested in attending both the ASOA and Technicians & Nurses programs. Crossover between the ASOA and Technicians & Nurses programs will be permitted to those registered in the joint registration category only. Those registered for either the ASOA or Technicians & Nurses program will not be allowed to go between the two programs. Registrants of either category are permitted to attend ASCRS courses/paper sessions/symposia. For planning purposes, approximate walking time between ASOA and T&N classrooms in 5 to 10 minutes.
REGISTRATION CATEGORIES WAYS TO REGISTER Web AnnualMeeting.ascrs.org Email mbraxton@ascrs.org Mail ASCRS ASOA 2017 c/o Convention Data Services 107 Waterhouse Road Bourne, MA 02532 Cancellation/Refund Policy All cancellations and requests for refunds must be in writing and received no later than April 14, 2017. A handling fee of $150.00 will be deducted from each cancelled registration. The membership dues portion of the registration fee is nonre-fundable. NO REFUNDS will be given after April 14, 2017. ASCRS Member: An MD, PhD, or DO who is a current member of ASCRS. Registration fee does not include annual membership dues. (Note: An MD, PhD, or DO who is a member of ASOA only must join ASCRS and pay appropriate membership dues.) Resident/Fellow An MD or DO who is currently in a residency or fellowship program. A current letter of verification from department chairperson or fellowship sponsor must accompany the registration along with a picture ID that includes proof of date of birth. The maximum age limit for a resident/fellow is 35 years old. Letters and credentials, which will be verified, can be faxed along with your registration to (703) 434-3004. Your registration will not be complete until your residency/fellowship documentation has been received and approved. All residency/ fellowship documentation must be received by April 14, 2017, to be eligible for the discounted rate. Young Physician A domestic MD or DO who is in the first two years of practice. To be eligible, an ophthalmologist must have been an ASCRS Resident/Fellow member and become a Young Physician Member immediately upon completion of training. Corporate/Other Manufacturers and other corporate personnel who do not have exhibit space but wish to attend the Symposium and Congress. NO solicitation is permitted. This includes attendees who plan on attending the exhibit hall only. Physicians cannot register in this category. ASOA Member Office administrator or other who is a current Professional (Domestic & International), Consultant or Vendor member of ASOA. Specialty Staff members and Trial members will need to upgrade to a full membership in order to register in this category. Physicians cannot register in this category. ASOA Nonmember Office nonclinical staff who are not current members of ASOA. ASOA Specialty Staff members and Trial members may also register in this category if they do not wish to upgrade their membership. Physicians cannot register in this category. Technicians & Nurses Ophthalmic assistants, technicians, technologists and nurses program. Physicians cannot register in this category. Integrated Eyecare Optometrists Optometrists (ODs) can register under this category only and must certify one of the following: Employed by an ophthalmologist Employed by a medical school (not a college of optometry) Employed by a managed-care provider Employed by the military Employed by industry/manufacturer Employed by a corporate center (TLC, LCA, etc.) Attendance at or participation in ASCRS Symposium and ASOA Congress programs, events, courses, presentations or other activities does not qualify an optometrist to perform surgery, does not qualify as continuing medical education, and does not justify claims to surgical expertise or licensure. Guests Guests 21 years of age and over are required to pay a registration fee. Fee includes badge, printed program, entrance into the exhibit hall, ASOA Party and the Film Festival Awards Ceremony. This badge is limited to spouse, guest, relative, or other individual accompanying an ASCRS or ASOA member. Members, potential members, or staff will not be considered under the spouse/guest registration category. Physicians/ASCRS ASOA members cannot register in this category. (Entrance into sessions/courses is not included.)
REGISTRATION FORM 1. Registration & Badge Information FIRST NAME M.I. LAST NAME/FAMILY NAME DEGREE AND/OR CERTIFICATION PRACTICE NAME CITY STATE ZIP COUNTRY BUSINESS TELEPHONE FAX EMAIL (FOR PHYSICIANS ONLY): HOW MANY YEARS HAVE YOU BEEN IN PRACTICE? Integrated Eyecare Optometrist All optometrists (ODs) must complete the following before the registration form can be processed. I certify that my employment situation falls into one of the following categories: employed by an ophthalmologist, a medical school (not a college of optometry), a managed-care provider, the military, industry/manufacturer, a corporate center (TLC, LCA, etc). Name and address of employer (PLEASE PRINT): I understand and agree that my attendance at or participation in the Integrated Eyecare Program and in ASCRS Symposium or ASOA Congress programs, events, presentations, or other activities does not qualify me to perform surgery and does not justify claims to surgical expertise or licensure. Signature: Date: 2. Registration Fees 3. Membership Dues CATEGORY CAT.# FEE ASCRS ASOA ASCRS Refractive Day 2017 ASCRS Glaucoma Day 2017 Cornea Day 2017 ASOA Nonmember (To become a member before registering, go to www.asoa.org.) Joint ASOA/Technician & Nurses Technicians & Nurses Integrated Eyecare Optometrist Physician Assistants 4. Guest Fee: $180 Must be a guest of a registered attendee. Limit 2 guests per registered attendee. Guests 21 years of age and over are required to pay a registration fee. ASCRS ASOA and Cornea Society assumes no liability for guests. All guests are the sole responsibility of the registered attendee. (Does not include entrance into session/courses.) Physicians/members may not register in this category. Total 2. Registration Fee $ 3. Membership Dues $ 4. Guest Fee $ 5. Total Payment Enclosed $ Registration fee does not include ASCRS or ASOA annual membership dues. NOTE: If you are registering as an ASCRS or ASOA member, dues must be current through May 31, 2017. Add membership dues to your registration if it is to expire before this date. ASCRS Membership Dues Domestic (1-Year Membership) $495 ASCRS Membership Dues International (1-Year Membership) $295 ASOA Membership Dues (1-Year Membership) $295 ASOA Consultant/Vendor Member Dues (1-Year Membership) $375 ASCRS Domestic Resident/Fellow Complimentary 5. Payment Method (U.S. Funds Only) Payment Must Accompany Registration Form ASCRS ASOA is hereby authorized to adjust registration charges originally paid via mail, phone, or Internet using my credit card if the amount originally paid was deficient or excessive by charging or crediting my credit card account and providing a mailed notice of the adjustment. Check (Payable to ASCRS mail to address above) Wire Transfer (Call for Details): Bank processing fees must be included in the payment for completion of registration. All funds must be received by April 14, 2017 (or you must register on site). Domestic (800)748-5064 or international at (508) 743-0538. Credit Card: MasterCard VISA AMEX Discover CREDIT CARD NUMBER CARDHOLDER SIGNATURE NAME OF CARDHOLDER (PLEASE PRINT) EXPIRATION DATE SECURITY CODE
HOTEL & TRAVEL INFORMATION ASCRS ASOA has designated onpeak as the official housing management company for the 2017 Symposium and Congress. We have negotiated a special but limited availability room rate with the Los Angeles hotels. We urge you to act now to secure your accommodations through onpeak. Deadline for housing reservations is Monday, April 3, 2017. Because hotel rooms are available via the Internet, ASCRS ASOA has not blocked the same number of rooms as in the past. We encourage you to make hotel reservations early. HOTEL RESERVATIONS Reservations can be made online or by phone. We are no longer accepting hotel reservation forms. Agents are available to answer questions and process reservations Monday to Friday, 9:00 a.m. 8:00 p.m. ET. Online ascrs.org/gethousing Phone (800) 370-8282 U.S. Toll-Free (312) 527-7300 Local/International Email ASCRS-ASOA@onpeak.co HOTEL ACKNOWLEDGEMENTS Confirmations will be emailed within 72 hours of receiving your reservation request. RESERVATION DEADLINE The deadline for reservations is Monday, April 3, 2017. Room rates are guaranteed before this deadline provided rooms are available at your chosen hotel. After the deadline, onpeak will make every attempt to locate rooms at official hotels but cannot guarantee rates or availability. CANCELLATIONS Payment Guarantee: No charges are incurred at the time of booking, however, a payment guarantee is required to hold your reservation in the amount of one night s stay at the confirmed hotel plus current tax of up to 14.5%, plus up to $3 per person depending on the size of the hotel. The hotel will charge payment to the credit card provided upon check-in. Please refer to your confirmation for full details, which may vary per hotel. Cancellation Policy: Reservations cancelled less than 7 days from the confirmed check-in date or not cancelled at all (no-show) are subject to loss of deposit. Please refer to your reservation confirmation for full policy details, which may vary per hotel. SUITES Attendees can request information on sleeping suite availability by contacting onpeak. Requests for suites for purposes other than sleeping must go through the ASCRS ASOA office. Contact the Meetings Department by phone, (703) 591-2220, or email affiliatemeetings@ascrs.org. TRAVEL ASCRS ASOA has negotiated discounted rates for travel to and from the meeting. More information will be available at AnnualMeeting.ascrs.org. VISA INFORMATION See AnnualMeeting.ascrs.org for information on visa procedures.
OFFICIAL HOTEL LIST & MAP DOWNTOWN HOTELS 1 Courtyard Los Angeles LA Live 901 W Olympic Blvd $267 Single/Double 2 Figueroa Hotel 939 S Figueroa St $329 Single/Double 3 Freehand Hotel 416 W 8 th St $245 Single/Double 4 JW Marriott Hotel at LA Live HQ Hotel 900 W Olympic Blvd $302 Single/Double 5 Residence Inn Los Angeles LA Live 901 W Olympic Blvd $279 Single/Double 6 Doubletree by Hilton Los Angeles Downtown 120 S Los Angeles St $269 Single/Double 7 Hilton Checkers Los Angeles 535 S Grand Ave $269 Single/Double 8 Hotel Indigo Los Angeles at Metropolis 889 Francisco St $319 Single/Double 9 LUXE City Center Hotel 1020 S Figueroa St $275-$339 Single/Double 10 LA Hotel Downtown 333 S Figueroa St $269 Single Standard / $329 Junior Suite 11 The Line Hotel 3515 Wilshire Blvd $250 Single/Double 12 The Mayfair Hotel Los Angeles 1256 W 7 th St $159 Single/Double 13 Millennium Biltmore Hotel 503 S Grand Ave $206 Standard / $261 Club 14 Miyako Hotel Los Angeles 328 E First St $229 Single/Double 15 O Hotel 819 S Flower St $253 Single/Double 16 Omni Los Angeles Hotel 251 Olive Street $295 Standard / $350 Club 17 Radisson Hotel at USC Los Angeles 3540 S Figueroa St $189 Single/Double 18 The Ritz Carlton, Los Angeles 900 W Olympic Blvd $427 Single/Double 19 Sheraton Los Angeles Downtown Hotel 711 S Hope St $290 Single/Double 20 The Standard Downtown LA 550 S Flower St $275 Single 21 The Westin Bonaventure Hotel & Suites 404 S Figueroa St $230 Single/Double HOLLYWOOD HOTELS 22 Dream Hotel Hollywood 6417 Selma Ave $285 Single/Double 23 The Garland Hotel Hollywood 4222 Vineland Ave $239 Single/Double 24 Hilton Garden Inn 2005 N Highland Ave $224 Single/Double 25 Hilton Los Angeles/Universal City 555 Universal Hollywood Dr $269 Single/Double 26 Hollywood Roosevelt Hotel 7000 Hollywood Blvd $305 Single/Double 27 Loews Hollywood Hotel 1755 Highland Ave $269 Single/Double 28 W Hollywood 6250 Hollywood Blvd $339 Single/Double 29 Sheraton Universal 333 Universal Hollywood Dr $259 Single/Double BEVERLY HILLS / WEST SIDE 30 Four Seasons Hotel at Beverly Hills 300 S Doheny Dr $425 Standard / $475 Premier / $595 Hollywood Suite 31 Intercontinental Century City 2151 Ave of the Stars $299 Single/Double 32 Sofitel Los Angeles 8555 Beverly Blvd $299 Single/Double 33 The Beverly Hilton 9876 Wilshire Blvd $314 Single/Double 50
OFFICIAL HOTEL LIST & MAP DOWNTOWN HOTELS 1 Courtyard Los Angeles LA Live 901 W Olympic Blvd $267 Single/Double 2 Figueroa Hotel 939 S Figueroa St $329 Single/Double 3 Freehand Hotel 416 W 8 th St $245 Single/Double 4 JW Marriott Hotel at LA Live HQ Hotel 900 W Olympic Blvd $302 Single/Double 5 Residence Inn Los Angeles LA Live 901 W Olympic Blvd $279 Single/Double 6 Doubletree by Hilton Los Angeles Downtown 120 S Los Angeles St $269 Single/Double 7 Hilton Checkers Los Angeles 535 S Grand Ave $269 Single/Double 8 Hotel Indigo Los Angeles at Metropolis 889 Francisco St $319 Single/Double 9 LUXE City Center Hotel 1020 S Figueroa St $275-$339 Single/Double 10 LA Hotel Downtown 333 S Figueroa St $269 Single Standard / $329 Junior Suite 11 The Line Hotel 3515 Wilshire Blvd $250 Single/Double 12 The Mayfair Hotel Los Angeles 1256 W 7 th St $159 Single/Double 13 Millennium Biltmore Hotel 503 S Grand Ave $206 Standard / $261 Club 14 Miyako Hotel Los Angeles 328 E First St $229 Single/Double 15 O Hotel 819 S Flower St $253 Single/Double 16 Omni Los Angeles Hotel 251 Olive Street $295 Standard / $350 Club 17 Radisson Hotel at USC Los Angeles 3540 S Figueroa St $189 Single/Double 18 The Ritz Carlton, Los Angeles 900 W Olympic Blvd $427 Single/Double 19 Sheraton Los Angeles Downtown Hotel 711 S Hope St $290 Single/Double 20 The Standard Downtown LA 550 S Flower St $275 Single 21 The Westin Bonaventure Hotel & Suites 404 S Figueroa St $230 Single/Double HOLLYWOOD HOTELS 22 Dream Hotel Hollywood 6417 Selma Ave $285 Single/Double 23 The Garland Hotel Hollywood 4222 Vineland Ave $239 Single/Double 24 Hilton Garden Inn 2005 N Highland Ave $224 Single/Double 25 Hilton Los Angeles/Universal City 555 Universal Hollywood Dr $269 Single/Double 26 Hollywood Roosevelt Hotel 7000 Hollywood Blvd $305 Single/Double 27 Loews Hollywood Hotel 1755 Highland Ave $269 Single/Double 28 W Hollywood 6250 Hollywood Blvd $339 Single/Double 29 Sheraton Universal 333 Universal Hollywood Dr $259 Single/Double BEVERLY HILLS / WEST SIDE 30 Four Seasons Hotel at Beverly Hills 300 S Doheny Dr $425 Standard / $475 Premier / $595 Hollywood Suite 31 Intercontinental Century City 2151 Ave of the Stars $299 Single/Double 32 Sofitel Los Angeles 8555 Beverly Blvd $299 Single/Double 33 The Beverly Hilton 9876 Wilshire Blvd $314 Single/Double 50
LOS ANGELES CONVENTION CENTER 1201 S, Figueroa St, Los Angeles, CA 90015 DOWNTOWN 1 COURTYARD LOS ANGELES L.A. LIVE 2 FIGUEROA HOTEL 3 FREEHAND HOTEL 4 JW MARRIOTT HOTEL AT L.A. LIVE 5 RESIDENCE INN LOS ANGELES L.A. LIVE 6 DOUBLETREE BY HILTON DTLA 7 HILTON CHECKERS LOS ANGELES 8 INDIGO AT METROPOLIS 9 LUXE CITY CENTER HOTEL 10 L.A. HOTEL DOWNTOWN 11 THE LINE HOTEL 12 HISTORIC MAYFAIR HOTEL 13 MILLENNIUM BILTMORE HOTEL 14 MIYAKO HOTEL LOS ANGELES 15 O HOTEL 16 OMNI LOS ANGELES HOTEL 17 RADISSON HOTEL AT USC LOS ANGELES 18 THE RITZ-CARLTON, LOS ANGELES 19 SHERATON L.A. DOWNTOWN HOTEL 20 THE STANDARD DOWNTOWN LA 21 THE WESTIN BONAVENTURE HOTEL & SUITES HOLLYWOOD 901 W. Olympic Blvd. 939 S. Figueroa St. 416 W. 8th St. 900 W. Olympic Blvd. 901 W. Olympic Blvd. 120 S. Los Angeles St. 535 S. Grand Ave 889 Francisco St. 1020 S. Figueroa St. 333 S. Figueroa St. 3515 Wilshire Blvd. 1256 W. 7th St. 506 S. Grand Ave. 328 E. First St. 819 S. Flower St. 22 DREAM HOTEL HOLLYWOOD 23 THE GARLAND HOTEL HOLLYWOOD 24 HILTON GARDEN INN 25 HILTON LOS ANGELES/UNIVERSAL CITY 26 HOLLYWOOD ROOSEVELT HOTEL 27 LOEWS HOLLYWOOD HOTEL 28 W HOLLYWOOD 29 SHERATON UNIVERSAL 6417 Selma Ave. 4222 Vineland Ave. 2005 N. Highland Ave. 555 Universal Hollywood Dr. 7000 Hollywood Blvd. 1755 Highland Ave. 6250 Hollywood Blvd. 333 Universal Hollywood Dr. BEVERLY HILLS/WEST SIDE 30 FOUR SEASONS HOTEL AT BEVERLY HILLS 31 INTERCONTINENTAL CENTURY CITY 32 SOFITEL LOS ANGELES 33 THE BEVERLY HILTON 300 S. Doheny Dr. 2151 Ave of the Stars 8555 Beverly Blvd. 9876 Wilshire Blvd. 251 Olive Street 3540 S. Figueroa St. 900 W. Olympic Blvd. 711 S. Hope St. 550 S. Flower St. 404 S. Figueroa St. 51