Pharmacology for Advance Practice Clinicians

San Francisco, CA · October 27-November 1, 2009
Register Now

Conference Overview

Advanced practice clinicians – NP’s, CNM’s, CNS’s, CRNA’s and PA’s – are cost-effective members of the primary care team and have now gained prescriptive authority in all states. Although the details of prescribing privileges vary from state to state, many states also have broadened the scope of their prescribing laws to include the furnishing of controlled substances as well as a wider range of drugs used to treat acute and chronic health problems.
In response to expanded prescriptive authority for APC’s, Contemporary Forums is offering these regional courses designed to review, expand and update your knowledge of pharmacology in preparation, and as required by law in many states, for attaining or renewing prescriptive authority.* Physicians and pharmacists will also find the information useful as a clinical update and preparation for board exams. Each course will cover therapeutic principles for many common medications used in primary care and will include case illustrations for clinical application.

Highlights and Benefits

Back by popular demand! Three of this year’s courses again include the Pre-Conference,“Pediatric Pharmacology Update,” focusing on medications and prescribing regimens for common and complex pediatric health problems. This Pre-Conference was presented at the 2008 Pharmacology Course and received rave reviews!
You will broaden your scope of practice and knowledge of pharmaceuticals and make yourself more “marketable” in this changing health care environment.

The course instructors are experienced and knowledgeable and have a relaxed and entertaining teaching style.

Through a case-based and interactive approach, the instructors will help you apply the content to clinical situations you deal with on a daily basis.

Daily registration is available for participants with selective needs for renewing or updating their prescriptive authority and knowledge of pharmacology.

Regional placement makes access to the courses available to everyone.

The content required by the California BRN in order for NP’s and CNM’s to prescribe Schedule II Controlled Substances is included on Friday at the Las Vegas and San Francisco courses.

Principal Instructors

Dr. Alan P. Agins earned a PhD in Pharmaceutical Sciences from the University of Rhode Island. He has held faculty appointments at Brown Medical School, Northeastern University School of Pharmacy and University of Virginia School of Nursing. During his tenure at Brown, he received the “Dean’s Teaching Excellence Award” over five consecutive years for his outstanding pharmacology lectures. Dr. Agins has also taught graduate & post-graduate pharmacology courses at a number of nursing schools around the country including Penn State, Idaho State, Radford, University of West Virginia and University of Arizona.
Over the past 15 years, Dr. Agins has lectured nationally to more than 50,000 advanced practice clinicians and allied health professionals. He is a regularly invited speaker at annual Conferences for a number of national, regional and state nursing organizations. Dr. Agins contributes to various journals, continuing education monographs and pharmacology textbooks as a writer and reviewer. He has also written and “starred” in a series of fun online educational video clips to support nursing pharmacology textbooks and has authored an educational DVD (+ workbook) for Elsevier. Additionally, he currently serves as a consultant to Pharmavite LLC (Nature Made).

Jody F. Agins, MSN, ARNP, FNP/GNP-BC received an ADN from Kansas City Kansas Community College, BSN from Webster University and an MSN/Family Nurse Practitioner from the University of Kansas. She has held faculty appointments at the University of Kansas and Truman State University.
Mrs. Agins is board certified by the ANCC in Family Practice and Gerontology. She currently works full time for Evercare-Tucson (United Healthcare Group), maintains a part-time private practice, lectures regularly for the University of Phoenix Nurse Practitioner Program, and is an invited speaker by a number of national, regional and local organizations. She is also a clinical preceptor for Family and Geriatric Nurse Practitioner students in Tucson and is a former member of the Board of Directors for NPACE.

The “take-home-message” that Dr. Agins and Mrs. Agins attempt to instill is to adopt a profound respect for, but also cautious attitude about drugs - what they can do … and what their limitations are. After many years “on the road” and every conceivable pharmacology question from their audiences, they maintain their great sense of humor and wit, as well as a unique talent for breathing life into dry or difficult subject matter. Their goal is to make this course memorable, informative and enjoyable … essentially the very best pharmacology CE experience for everyone who attends.

Conference Objectives

Upon completion of the course, the participant will be able to:

  • Explain the pharmacology and pharmacokinetics of the drugs discussed for each clinical condition.
  • Discuss pharmaceutical options and choose the most appropriate drug or drug class for a disease, based on the patient’s signs, symptoms, lifestyle and other health conditions.
  • Utilize patient monitoring techniques to assess the impact and efficacy of drug treatment.
  • Anticipate potential side effects, recognize adverse reactions and discuss their management.
  • Demonstrate clinical application of the pharmacology content through case study discussion.
  • Provide appropriate patient education regarding drug therapy for a given disease state.
  • Discuss the pharmacology of herbs and supplements, including mechanisms of actions, side effects and indications and contraindications.
  • Recognize the professional and legal aspects of prescribing and furnishing drugs.

Who Should Attend?

  • Nurse Practitioners
  • Certified Nurse-Midwives
  • Clinical Nurse Specialists
  • Physician Assistants
  • Registered Nurses
  • Nurse Educators
  • Certified Registered Nurse Anesthetists
  • Physicians
  • Pharmacists

Online CE Library

The Contemporary Forums Online CE Library is an on-demand resource for accredited continuing education for healthcare professionals. Multi-media content is captured from our live Conferences and continually updated. The library contains thousands of CE credit hours available from a wide variety of specialty areas. Visit www.onlinecelibrary.com for details and free previews.

Group Access

Facilities can arrange for their staff to have Online CE Library access at reduced rates.
Call 800-377-7707, Ext. 5145, for details


Conference Program

Tuesday, October 27 | Wednesday, October 28 | Thursday, October 29 | Friday, October 30 | Saturday, October 31 | Sunday, November 1

Pre-Conference

Pediatric Pharmacology Update

(Rx = 7.25 hrs.) ACPE #263-000-09-022-L01-P 7.25 Contact Hours/.725 CEU’s

Patricia Reiter Becker, MS, FNP

Victoria Weill, MSN, CPNP-PC

Locations:

  • Philadelphia August 3 (Monday)
  • Las Vegas September 14 (Monday)
  • San Francisco October 26 (Monday)

NOTE:This Pre-Conference will not be presented in Nashville and is not being recorded.

Keeping up with information on the medications you prescribe when caring for children is indeed a challenge. Plan now to join your colleagues for what promises to be an information-packed day on drugs used for common pediatric health problems. Taught by two clinicians and educators, this update will enable you to better:

  • Identify medications and prescribing regimens for common and complex pediatric health problems.
  • Anticipate potential side effects and adverse reactions and discuss their management.
  • Evaluate the effectiveness of a variety of treatment regimens through interactive case study sessions.
7:00 a.m. Pre-Conference Registration Check-In
8:00 Treating Infectious Conditions of the Ear and Eye
Otitis Media; Otitis Media with Effusion; Otitis Externa
Conjunctivitis
9:15 Managing Respiratory Problems
Asthma
10:15 Break
10:30 Managing Respiratory Problems (continued)
Pneumonia/Bronchiolitis
Allergic Rhinitis
11:45 Questions and Discussion
12:00 p.m. Lunch Break
1:15 Common Dermatologic Conditions
Acne
Atopic Dermatitis
Impetigo, MRSA & Others
2:45 Managing GERD in Children
3:30 Break
3:45 Immunization Update
4:45 Questions and Discussion
5:00 Adjourn

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Main Conference

Locations & Dates:

  • Philadelphia August 4 – 9 (Tues.- Sun.)
  • Nashville August 25 – 30 (Tues. - Sun.)
  • Las Vegas September 15 – 20 (Tues. - Sun.)
  • San Francisco October 27 – November 1 (Tues. - Sun.)

Tuesday

ACPE #263-000-09-023-L01-P 8.5 Contact Hours/.85 CEU’s

(Rx = 8.5 hrs.)

Note: The Philadelphia course begins at 7:30 a.m. on Tuesday and ends at 5:30 p.m.

7:00 a.m. Registration Check-In
8:00 Introduction: The Fundamentals of Pharmacology and Therapeutics (Including Drug Interactions)
Alan P. Agins, PhD
Pharmacodynamics and Pharmacokinetics
12:00 p.m. Lunch Will Be Provided
1:00 Cardiovascular Pharmacology (Part 1)
Alan P. Agins, PhD
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
Metabolic Syndrome
Hypertension
Dyslipidemia
Type 2 Diabetes (Including Obesity)
6:00 Adjourn

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Wednesday

ACPE #263-000-09-024-L01-P 8 Contact Hours/.8 CEU’s (= 8 hrs.)

7:30 a.m. Registration Check-In
8:00 Infectious Disease Pharmacology
Alan P. Agins, PhD
Antibiotics
Antifungals
Antivirals
12:00 p.m. Lunch on Your Own
1:00 Treating Infections: Guidelines and Case Studies
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
Otitis/Sinusitis
Community-Acquired Pneumonia
MRSA
C.difficile
Dermatology
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
Understanding the Basics of HIV Therapy
Alan P. Agins, PhD
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
5:30 Adjourn

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Thursday

ACPE #263-000-09-025-L01-P 8 Contact Hours/.8 CEU’s (= 8 hrs.)

7:30 a.m. Registration Check-In
8:00 Endocrine Pharmacology
Alan P. Agins, PhD
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
Bone Health
Neuropharmacology
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
Dementia and Delirium
- Drugs for Cognition
- Antipsychotics
- Antiepileptics
12:00 p.m. Lunch on Your Own
1:00 Psychopharmacology
Alan P. Agins, PhD
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
Antipsychotics (continued)
Antidepressants
Antianxiety/Sedative-Hypnotics
5:30 Adjourn

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Friday (*Schedule II Requirements)

ACPE #263-000-09-026-L01-P 8 Contact Hours/.8 CEU’s (= 8 hrs.)

7:30 a.m. Registration Check-In
8:00 Stimulants for ADHD*
Alan P. Agins, PhD
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
Opioid Analgesics*
Alan P. Agins, PhD
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
10:45 Legal Aspects of Prescribing*
Steven W. Gray, PharmD, JD (San Francisco)
Carolyn Buppert, JD, MSN, CRNP (Philadelphia/Nashville/Las Vegas)
12:30 p.m. Lunch on Your Own
1:30 Prescription Drug Abuse
Alan P. Agins, PhD
Anti-Inflammatory Drugs
Alan P. Agins, PhD
Neuropathic Pain/Migraine Headaches
Alan P. Agins, PhD
Jody F. Agins, MSN, ARNP, FNP/GNP-BC
Antidepressants
Antiepileptics
Analgesics
Triptans
Others
5:30 Adjourn

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ATTENTION:
California Nurse Practitioners & Nurse-Midwives

*Prescribing Schedule II Controlled Substances
Content to meet the requirements of the California Board of Registered Nursing to furnish Schedule II medications will be presented on Friday in Las Vegas and San Francisco. California NP’s and CNM’s who already have a furnishing number may register for Friday only in Las Vegas or San Francisco and will receive a Schedule II certificate. The CA BRN requirements will NOT be presented at the Philadelphia and Nashville courses.


Saturday

ACPE #263-000-09-027-L01-P 8 Contact Hours/.8 CEU’s (= 8 hrs.)

Note: The Philadelphia course begins at 7:30 a.m. on Saturday and ends at 5:00 p.m.

7:30 a.m. Registration Check-In
8:00 Respiratory Pharmacology: A Case Study Approach
Jamie Lynch, MSN, ARNP
Allergies
Asthma
COPD
Special Considerations in the Elderly
National Guidelines Review
Questions and Discussion
11:00 Women’s Health Drugs
Patricia Geraghty, MS, RN, FNP
Hormonal Contraception
Hormone Therapy
Contraindications During Pregnancy and Lactation
Case Reviews
12:30 p.m. Lunch on Your Own
1:30 Women’s Health Drugs (continued)
3:30 Herbals and Dietary Supplements
Candy Tsourounis, PharmD (Philadelphia/Nashville)
Cathi Dennehy, PharmD (Las Vegas/ San Francisco)
5:30 Adjourn

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Sunday

ACPE #263-000-09-028-L01-P 4.5 Contact Hours/.45 CEU’s (Rx = 4.5 hrs.)

7:30 a.m. Registration Check-In
8:00 Cardiovascular Pharmacology (Part 2): A Case Study Approach
Jamie Lynch, MSN, ARNP
Angina - Risk Factors/Insulin Management
Atrial Fibrillation
Congestive Heart Failure
Special Considerations in the Elderly
National Guidelines Review
Questions & Discussion
11:30 Review Self-Assessment Post-Test
12:30 p.m. Conference Summary/Evaluation
12:45 Adjourn

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Faculty

Alan P. Agins, PhD
President, PRN Associates
Continuing Healthcare Education
Tucson, Arizona

Jody F. Agins, MSN, ARNP, FNP/GNP-BC
Family and Geriatric Nurse Practitioner
Evercare - Tucson (United Healthcare Group)
Executive Director, Seminars for Healthcare Education, Inc.
Tucson, Arizona

Patricia Reiter Becker, MS, FNP
Lead Nurse Practitioner, Philadelphia Market
Take Care Health Services
Philadelphia, Pennsylvania
Nurse Practitioner, Broomall Pediatrics
West Chester, Pennsylvania

Carolyn Buppert, JD, MSN, CRNP
Author: Prescribing: Preventing Legal Pitfalls (2006)
The Nurse Practitioner’s Business Practice
and Legal Guide (2007)

Attorney, Health Care Law
Law Office of Carolyn Buppert, P.C.
Bethesda, Maryland

Cathi Dennehy, PharmD
Associate Clinical Professor of Clinical Pharmacy
University of California San Francisco School of Pharmacy
San Francisco, California

Patricia Geraghty, MS, RN, FNP
Adjunct Clinical Faculty, Holy Names University
Oakland, California
Nurse Practitioner, Muir ObGyn Medical Group
Walnut Creek, California

Steven W. Gray, PharmD, JD
Pharmacy Regulatory Compliance and Professional Affairs
Leader for a California Managed Care Organization
Downey, California

Jamie Lynch, MSN, ARNP
Nurse Practitioner
Orlando Heart Center
Orlando, Florida

Candy Tsourounis, PharmD
Professor of Clinical Pharmacy
Medication Outcomes Center
University of California San Francisco School of Pharmacy
San Francisco, California

Victoria Weill, MSN, CPNP-PC
Associate Program Director
Primary Care Pediatric Nurse Practitioner Program
University of Pennsylvania School of Nursing
Philadelphia, Pennsylvania
Pediatric Nurse Practitioner
North Penn VNA Children’s Clinic
Lansdale, Pennsylvania

Accreditation

A Certificate of Attendance is given upon completion of course requirements, enabling you to register your credit with the appropriate licensing boards or associations. To apply for credit not listed below, use the procedure established by the specific organization. Additional brochures and evaluation forms provided upon request.

Nurses and Nurse Practitioners

Pediatric Pharmacology Pre-Conference:
7.25 ANCC/8.7 CA BRN contact hours

Pharmacology Course:
45 ANCC/54 CA BRN contact hours
Contemporary Forums is accredited as a provider of continuing nursing education by the American Nurses CredentialingCenter’s Commission on Accreditation.

Contemporary Forums is approved by the California Board of Registered Nursing, Provider #04516.
(CA BRN contact hour = 50 minutes)

Application for contact hours will be made to the Ohio Nurse Association, an accredited approver by the ANCC.

Physicians

Pediatric Pharmacology Pre-Conference:
7.25 credit hours

Pharmacology Course:
45 credit hours

Contemporary Forums is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Contemporary Forums designates this educational activity for a maximum of the listed AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurse-Midwives

Pediatric Pharmacology Pre-Conference:
7.25 hours

Pharmacology Course:
45 hours

The Continuing Education Committee of the American College of Nurse-Midwives grants reciprocity status to the Accreditation Council for Continuing Medical Education (ACCME) for Category 1 offerings, providing the program is relevant to nurse-midwifery. Nurse-Midwives may report up to the listed hours of credit.

Physician Assistants

Pediatric Pharmacology Pre-Conference:
7.25 hours

Pharmacology Course:
45 hours

The American Academy of Physician Assistants accepts Category 1 CME approval from organizations accredited by the ACCME to grant Category 1 hours toward the Physician’s Recognition Award. PA’s may report up to the listed hours of credit.

Pharmacology Credit for Prescriptive Authority

Pediatric Pharmacology Pre-Conference:
7.25 hours

Pharmacology Course:
45 hours available

Rx indicates sessions with pharmacology content. Because states’ requirements vary, contact your Board of Nursing for more information.

Pharmacists

Pediatric Pharmacology Pre-Conference:
7.25 hours/.725 CEU’s

Pharmacology Course:
45 hours/4.5 CEU’s available

ACPEContemporary Forums is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Statements of Credit will be distributed at course completion in exchange for a completed Conference Evaluation and Attendance Verification Form.

Exhibits

To enhance your educational experience, we are inviting representatives from professionally relevant companies, organizations and hospitals to exhibit equipment, supplies, services and career opportunities. The schedule provides participants time for one-on-one discussion with exhibitors. For exhibit space availability or additional information:

Call the Exhibitor Information Line: (925) 828-7100, Ext. 5260

For prospectus information

Email: exhibits@cforums.com

Location

San Francisco

San Francisco

San Francisco … Explore Fisherman’s Wharf with the frenetic energy of fishing boats, street performers and artists. At Pier 39 you’ll be amazed at the antics of hundreds of sea lions frolicking in the sun. Hop on a cable car and take in sweeping views of the bay, Alcatraz and the Golden Gate Bridge. You won’t want to miss Golden Gate Park and its gem, the de Young Museum. Explore San Francisco’s ethnic diversity ... Chinatown, North Beach, the Mission District and more. And shopping … from the delightful boutiques of Union and Chestnut Streets to the designer shops on Union Square, you won’t be disappointed.

The Hyatt Regency San Francisco, has an impressive 20-story garden atrium lobby and a view from every room. The Hyatt is surrounded by a multitude of shops and restaurants, including the newly renovated Ferry Building, bustling with a Farmer’s Market, gourmet shops and restaurants. The California Street cable car line and Embarcadero BART station are steps from the lobby of the hotel, giving you easy access to all the unique sites and sounds of San Francisco.

  • The Hyatt Regency San Francisco, 5 Embarcadero Center, San Francisco, CA 94111.
  • Hotel room release date: October 3, 2009
  • Rates: $219 single; $229 double occupancy
  • For room reservations please call (800) 233-1234. For additional hotel information, call the Hyatt Regency San Francisco at (415) 788-1234.

Hotel/Travel

Hotel Accommodations

Special group rates are in effect for participants and their guests, based on room availability and may be available before and after each Conference for those wishing to extend their stay. Please inquire when making your hotel reservation.

You must make your reservation early and before the “hotel room block release date” listed for each hotel. Rooms may sell out before this date so be sure to make your reservation now. After the release date, rooms and group rates may no longer be available so call the hotel for availability. Rates are per room and subject to prevailing state and local taxes.

For room reservations, call the hotel and inform them that you are attending the Contemporary Forums’ Pharmacology Course. Request a confirmation number and written confirmation of your reservation.

Contact the hotel regarding cancellation policy. For arrivals after 3 p.m., call the hotel on the day of travel to reconfirm reservations.

For assistance in locating a roommate, please call Contemporary Forums at (800) 377-7707, Ext. 0.

Travel Discounts

UNITEDContemporary Forums has a special discount agreement with United Airlines unavailable to the general public. To obtain these special Conference fares either go online at www.united.com or call the Special Meeting Desk at (800) 521-4041, Account Code 510CW. Ticketing and payment can be done directly by you or through your travel agent. To ensure the best flights and times, since seats are limited, make your reservations early. Fares are guaranteed at the time of ticket purchase.

JetBlue

Relax and stretch out before and after you hit the convention floor—you can now enjoy JetBlue’s award-winning service and roomy leather seats for less! Book now and choose your way to save:
Traveling by yourself —Use the following convention codes as you book on jetblue.com/promo to save 5% off your travel:

  • PharmPhilly for Philadelphia
  • PharmVegas for Las Vegas
  • PharmSF for San Francisco

Traveling as a group of five or more - Use JetBlue’s Meetings & Convention program to receive a customized fare. Simply call our dedicated desk at 888-JETBLUE, prompt 4. Your group will also receive one free change waiver per traveler.

HertzHertz is the official car rental agency for the onference. Special rates will be in effect throughout the Conference as well as one week before and after. For special rates, call HERTZ at (800) 654-2240 and refer to Contemporary Forums plus the Conference discount code CV# 03000210.

Fees

Registrations must include full tuition payment to be accepted. Registrations faxed without payment will not be processed. Confirmation is sent by email if your completed registration form and payment are received two weeks before the Conference begins. Since Conference registration and hotel rooms are limited, early registration is advised.

Out of consideration to registrants, children of any age and spouses may not attend the sessions.

Tuition Fee (U.S. Funds)

Pediatric Pharmacology Pre-Conference

Pharmacology Course

Daily Registration

Early Fee*
(On/before 30 days prior to start date)
$195
$745
*See Below
Regular Fee
(Within 29 days of start date))
$235
$835
*See Below

Tuition includes Program Syllabus, lunch on Tuesday, refreshment breaks and Certificate of Attendance. Registrations may not be shared.

* Daily Registration is Available

1 day $195 3 days $450 5 days $700
2 days $325 4 days $580

Please contact Contemporary Forums for daily CE hours since they vary.

California NP’s & CNM’s: Content to meet the requirements of the California Board of Registered Nursing to furnish Schedule II medications will be presented on Friday in Las Vegas and San Francisco. California NP’s and CNM’s who already have a furnishing number may register for Friday only in Las Vegas or San Francisco and will receive a Schedule II certificate. The CA BRN requirements will NOT be presented at the Philadelphia and Nashville courses.

Method of Tuition Payment

Make payment by check (payable to Contemporary Forums and enclose with Registration Form), Visa, MasterCard, Discover Card, American Express or Purchase Order. A $30 fee is charged for any returned check. Personal checks are NOT accepted at the Conference. Purchase Orders must be received with registration by the Conference date and include the P.O. number, invoice address, tuition, approval signature, and contact name, email address and phone number.

Register by Phone, Fax, Mail or Online (Payment required to register)

Register only ONCE, by mail, online at www.contemporaryforums.com, fax (800) 329-9923 or call (800) 377-7707, Ext. 5252, Monday-Friday, 8 a.m. - 5 p.m. (Pacific Time). Before calling, complete all registration information.

Tax Deductibility

Expenses of training, tuition, travel, lodging and meals to maintain or improve your professional skills may be TAX DEDUCTIBLE. Consult your tax advisor.

Cancellations

Cancellations may be made by phone or in writing. Cancellations received on/before 30 days prior to the start of the Conference receive a full tuition refund. Cancellations received after that date are assessed a $50 processing fee. No refunds for cancellations received after the Conference begins or for “no shows.” If this meeting is cancelled for any reason, including labor strikes or acts of God, liability is limited to a full refund of registration fees.

Program Changes

Contemporary Forums reserves the right to make necessary changes in speakers, topics or schedule. The most current program can be found on our website.

Questions?

Please contact Contemporary Forums at (800) 377-7707, Ext. 0, Monday - Friday, 8 a.m. - 5 p.m. (Pacific Time) or email info@cforums.com.

If you require special arrangements at this Conference, call (800) 377-7707, Ext. 5252, at least 30 days prior to the Conference.

Pharmacology for Advance Practice Clinicians
Download Brochure PDF

Excellent Conference, makes you re-think your prescribing practice to better benefit patient and family.

Kristen Lugger, MS, APNP, GNP
Oshkosh, WI

As our clients become more informed on pharmacological issues, this is a much needed class. It exceeded my expectations.

Linda Lindgust, CNP
Blaine, MN

Dr Agins and his wife Jody, serve as a wonderful, synergetic team to provide a thorough, comprehensive review of pharmacology and their clinical applications.

Shannon Ikenberry, RNC, WHN
Lexington, VA

This course provided an excellent review of all drug classes, up to date indications, new agents with applicable clinical indications based on evidence in the research. All presented in an engaging mode. A great review for the novice or experience nurse practitioner.

M. Michelle Forthouse, MS, NP, ACHPN
Fredericksburg, VA