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Disease Prevention News
Texas Department of Health
1100 West 49th Street
Austin, TX 78756-3199
Address Service Requested
Periodicals Postage
Paid at Austin, TX
To register for the Texas Department of Health Quarterly CME Conference, call the TDH Public Health
Professional Education Program at (800) 252-8239, press 4, or (512) 458-7677. You may pay the registration
fee at that time by credit card or you may send a check with this completed form to the Texas Department
o Health 4C423-001, P.O. Box 149200, Austin, Texas 78714-9200.
4C423-001
Registration Fee: E $50 Regular
Name
Address
Registration Form
Perspectives in Public Health: Maternal and Child Health
Texas Department of Health Quarterly CME Conference
Friday, September 28, 2001 8:00 AM - 4:00 PM
l $25 Residents/Fellows (with verification letter) Q Please call me regarding special needs
0
SS # Change of Address Q Y Q N
Daytime Phone
City State Zip County
Discipline E MD
Q DO Q PA E Resident Q RN Q Other
Fax #
Employment Setting:
Internet Address
E TDH E Local Health Dept.
Q Private Practice
E Managed care E Other - Specify
Method of Payment Q Visa
Name on Card
l Mastercard l Check (Payable to "TDH 4C423-001")
Card #
For $ Expiration Date
Cardholder Signature
For information and to register, call (800) 252-8239 press 4 or (512) 458-7677.
To pay by check, include payment with this registration form and mail to
Texas Department of Health 4C423-001, P.O. Box 149200, Austin, Texas 78714-9200
Space Is Limited - Reservations Must Be Received By September 21, 2001
Disease Prevention News (ISSN 1068-7920)
Is a biweekly newsletter published by the
Texas Department of Health, Public Health
Professional Education, at 1100 West 49th
Street, Austin, TX 78756-3199, (512) 458-7677,
T D Hu FAX (512) 458-7340, email: dpn@tdh.state.tx.us.
T Periodicals Postage Paid at Austin, TX
POSTMASTER: Send address changes to
Disease Prevention News, 1100 West 49th
Street, Austin, TX 78756-3199.
The electronic version of Disease Prevention News, the
subscription form, and a searchable index of issues from
1995 are available at the following website:
http://www.tdh.state.tx.us/phpep/
J.C. Chambers, Chair, Texas Board of Health
Charles E. Bell, MD, Executive Deputy Commissioner
Debra C. Stabeno, MPH, Deputy Commissioner for
Programs
Sharilyn K. Stanley, MD, Associate Commissioner for
Disease Control and Prevention
Dennis M. Perrotta, PhD, CIC, State Epidemiologist
Mark V. Gregg, MA, Director, Public Health
Professional Education
DPN Staff
Kate Hendricks, MD, MPH&TM, Medical Editor
Susan Hammack, MEd, Managing Editor
Linda Darlington, Production Assistant
DPN Editorial Board
Suzanne S. Barth, PhD
Peter Langlois, PhD
Susan U. Neill, MBA, PhD
Sharilyn K. Stanley, MD
Lucina Suarez, PhD
TDH Publication #59-10940
Speciality.
PHPE Use Only
Amount
Rec'd
CC Posted