1 Speaker Form 2 Financial Disclosure 3 List of Disclosures 4 Sign Off

Speaker Form

Thank you for agreeing to speak at the 19th Biennial Eliza Fernie Pediatric Critical Care Symposium on April 23-24, 2024. Please complete the following form.
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Examples
Kay Kinzie, MSN, RN, FNP-BC
Clinical Manager
Immunodeficiency Program
Children’s Hospital Colorado

Adam Rosenberg, MD
Professor of Pediatrics
University of Colorado School of Medicine
Attending Neonatologist
Neonatal ICU and Special Care Clinic
Children’s Hospital Colorado
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