Register "*" indicates required fields Attendee InformationAttendee Type* Member Non-Member Applicant PA/ARNP/RN/TECH Resident Fellow Medical Student Practice Administrator Name* First M.I. Last Suffix Designation MD DO DFSVS FSVS FACS RPVI PA ARNP RN RVT Practice/Academic Institution NameAcademic TitleDepartmentEmail* Cell Phone*Work Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Onsite DIrectoryACCME guidelines require that GVS must receive your permission for your contact information to be included in the onsite attendee list and directory listed in the back of the final program.Do you give permission to have your contact information printed on the attendee list* Yes No RegistrationPractice Management Symposium Fri. - Practice Management (3:00-6:00 PM) Get ready to engage in thought-provoking discussions and gain valuable insights into the aspects of business development and reimbursement trends including Medicare and the outpatient shift to ASC’s. We will do a deep dive into two topics: Development of an Ambulatory Surgery Center in a Vascular Surgery Practice and Improving Standard and Alternative Revenue Streams in a Vascular Practice.GVS Annual Scientific Sessions Saturday 8:00 - 1:30p (Includes Lunch Symposium) Sunday 8:00 - 1:00p GuestsWill you be attending with a spouse or other guest?* Yes No Spouse Email Please enter your Spouse/Guest email to receive information about Hospitality Breakfast and ActivitiesPlease enter the name of your spouse/guest that will be onsitePlease enter the name(s) and ages of children under 18 who will be onsiteSpecial AccommodationsDo you or any guest have dietary restrictions or require other special accommodations?* Yes No Please list any dietary restrictions or special accommodationsActivitiesWhich events are you interested in? NEW - GVS Ritz Kids Pizza Party (Fri. 6-9pm) Ages 5-12 NEW - Georgia Safari Conservation Advenure (Sat. 2:30 - 4:30) all ages NEW - Hiking & Falconry Experience (Sat. 2-5) Pickleball Round Robin (Sat. 2-4) Sporting Clays (Sat. 2-5) Tennis Round Robin (Sat. 2-4) President's Tailgate (Sat 7-10) Family Hospitality Breakfast (Sat. & Sun.) GVS Ritz Kids Friday Night Pizza PartyRitz-Kids is available for GVS children ages 5-12 for Friday night from 6-9 pm Friday Night GVS Ritz-Kids Pizza Party Quantity* Price: $90.00 Quantity Ages 5-12 is $90 per childPlease enter the names and ages of each child participating.*Georgia Safari Conservation AdventureGeorgia Safari Conservation Tour begins at 2:30 pm. The Conservation Park is located at 1761 Monticello Road in Madison, Georgia about a 20-minute drive from the Ritz. GVS has a private tour bus scheduled for your Safari Adventure. Space is limited to 24 people. Children 2 and under can sit on parent's laps. You must register in advance of the meeting for this adventure. We only have 24 spaces available.Georgia Safari Conservation Adventure Quantity* Price: $35.00 Quantity $35.00 per person (children 2 and under may sit on parent's lap). Please enter the names and ages of each child participating.*Hiking & Falconry Experience1.5 hour hike at Sandy Creek Sporting Grounds and 30-minute Falconry demonstration. Please register in advance for this experience. We expect this to be full before 9-12-25.How many adult tickets do you need? Quantity* Price: $100.00 Quantity How many child tickets do you need? Quantity* Price: $0.00 Quantity Children 12 and under no chargePickleballHow many adult tickets do you need? Quantity* Price: $30.00 Quantity TennisHow many adult tickets do you need? Quantity* Price: $35.00 Quantity President's TailgateHow many adult tickets do you need? Quantity* Price: $75.00 Quantity Do you plan to bring children under the age of 18?* Yes No How many tickets do you need for children ages 12 to 17? Quantity Price: $50.00 Quantity Children under 3 are no chargeHow many tickets do you need for children under age 12? Quantity Price: $25.00 Quantity Children under 3 are no chargeSporting ClayHow many sporting clay tickets do you need? Quantity* Price: $120.00 Quantity GolfingThere is no organized golf tournament. To obtain a tee time, please email Emily Fishbaugh at efishbaugh@reynoldslakeoconee.com . Identify that you are with Georgia Vascular Society and a discounted golf rate will be offered. Include: date preferred starting time number of golfers PaymentTotal How would you like to pay?* Credit Card Check Please make checks payable to Georgia Vascular Society, Inc. 3439 Vestal Parkway East #238 Vestal, New York, 13850 Credit Card* CAPTCHA
