Registration Form
User Conference 2009

Join your friends at Healthcare Automation for our User Conference, September 23-25, 2009 in Newport, RI. This year the curriculum will focus on opportunities to maximize the potential of HomecareNet with features and processes used by your industry peers. Sessions will be interactive and exciting. See the tentative Conference Schedule for details. Please fill out one form for each person attending the conference. See you in Newport!

Name:
Title:
Company Name:
Address:
 
City, State, ZIP
Phone:
E-mail:

Registration

Early - prior to May 30th:

$350 (plus receive a free HomecareNet T-shirt!)
Preferred Size:

Regular - May 30th through Aug. 31st:

$450

Late - after Aug. 31st:

$550

Additional Clambake Dinner guest
(Thursday Sept. 24):

$110
Quantity:

Payment method

I'll send a check

Please call me for credit card information.

Hotel Reservations
Reservations at the Hyatt Regency Newport are being made directly through Healthcare Automation. Rates are $269/night (single or double) and do not include taxes. Your credit card information will be used to reserve your room, but actual payment will be made by attendees upon arrival at the hotel.

Arrival Date:
Departure Date:
Number of Occupants:

Please note that all room cancellations MUST be made by Sept. 4, 2009. Individuals cancelling after that date will see a charge to their credit card of the equivalent of one room night.

Pre-Conference Events
This year, Healthcare Automation is offering a tour of our offices before the conference begins. If you are interested in participating in any or all of these events, on Wednesday September 23, please check the appropriate boxes:

I would like to tour Healthcare Automation's Offices at 11 AM

I will attend the Steering Committee/Executive Session from 3 to 5 PM

I will attend the Welcome Reception from 6 to 9 PM.

Depending on the number of people interested, Pete Tanguay from Rock-Pond Solutions may sponsor a round of golf at the Newport National Golf Course. Once we determine the level of interest, we will provide you with more details. Please check the box below if you would be interested and when you would be available:

Wednesday AM

Wednesday PM


If you are mailing a check, please print this form (before clicking "submit") and mail it with your check to:
Healthcare Automation, Inc.
Adriana Aiken
41 Sharpe Drive
Cranston, RI 02920