Physicians – AAP Visiting Lectureship on Secondhand Smoke Exposure and Smoking Cessation – April 8, 2015 Please complete the form to register as a physician for the April 8, 2015 Session. Name (First and Last) * Credentials * MD MD, FAAP DO DO, FAAP Other Credentials - Other: Organization * Email * Please select all of the sessions that you will be attending: 7:00-8:00am - Grand Rounds - Addressing Second Hand and Smoking Cessation in the Pediatric Encounter 12:00-1:00pm - Lunch - How to Approach Tobacco Cessation for Family Members as Primary Care Physicians Involved with Children & Integrating Public Health and Primary Care to Reduce Tobacco Exposure 2:00-4:00pm - Community Panel Discussion - Integrating Secondhand and Smoking Cessation in Community Settings 5:30-7:30pm - Dinner & Training - The 5A's of Smoking Cessation Are you planning to join us for lunch and/or dinner? * Yes, and I do not have any dietary restrictions. Yes, and I do have dietary restrictions. No - I do not plan to be there for lunch and/or dinner. Lunch will take place from 12:00 - 12:45pm. Dietary Restrictions: If you are human, leave this field blank.