CSRF Patient Day 2019 - Facebook Source

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* 1. Please give us your name, full address, phone number, and e-mail address. Please make sure that your e-mail account will allow e-mails from "leslie@csrf.net" to ensure you receive communication.

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* 2. CSRF has a very limited number of rooms reserved in a block at the Emory Conference Center Hotel (ECCH). The full cost per night (including taxes and fees) is $160. Priority for the rooms will be given to attendees who can pay the full amount, but we have established a wait list for a limited number of 50% scholarships ($80 per night).

Do you want to reserve a room at ECCH? (PLEASE NOTE ALL BLOCK RESERVATIONS MUST BE DONE THROUGH CSRF - DO NOT CALL THE HOTEL DIRECTLY)

NOTE: IF OUR BLOCK SELLS OUT, THE HOTEL IS ALSO SOLD OUT ON ONE OR MORE OF THE CONFERENCE DATES. WE WILL PROVIDE A LIST OF LOCAL ACCOMMODATIONS FOR YOU TO CHOOSE FROM AND BOOK SEPARATELY IF THIS HAPPENS.

I do not need to book a room through CSRF at ECCH. I either do not need lodging or will make other arrangements for myself.

I want to book a room at ECCH and can pay the full cost of $160/night.

I want to book a room at ECCH but would like to be on the waiting list for a half-price room. I understand I will be notified by the end of August if I receive the scholarship.

If you would like to stay at ECCH, please indicate which nights: Thursday 10/3, Friday 10/4, and/or Saturday 10/5.

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* 3. If you prefer to stay at ECCH but we no longer have rooms available, what will you do?

I will find and book my own local lodging elsewhere.

I will request from CSRF a list of local options and choose one to book myself.

I will not want to be registered for the conference if I cannot stay at the ECCH.

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* 4. Please tell us your CONFIRMED ENDOGENOUS source of Cushing's (pituitary, adrenal, ectopic, etc.) and your diagnosis date.

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* 5. Please tell us which treatment(s) you have received - surgery, medication, radiation, etc.

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* 6. Will you bring a Caregiver? If so, please give us their name and relation to you.

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* 7. Do you have any dietary restrictions?

Yes

If yes, please list:

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* 8. Do you have questions or comments? Please list them here or e-mail to leslie@csrf.net and we will get back to you soon. Thank you!

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* 9. Please acknowledge that you understand that as of August 19, the date this link was shared on Facebook, we had about 15 spots remaining at this conference and that you should not book non-refundable travel until you receive written confirmation of your registration. We will start a wait list once we reach capacity. Historically there have usually been several last minute cancellations at our conferences, so placement on a wait list does not necessarily mean you will not be able to come. The latest you would be notified is Monday, September 16.

I will not book non-refundable travel until I receive a registration confirmation. I DO wish to be on the wait list if you receive this registration after you reach capacity.

I will not book non-refundable travel until I receive a registration confirmation. I DO NOT wish to be on the wait list if you receive this registration after you reach capacity.