Live-Patient Surgery Training Course in Tijuana, Mexico 25 CEU

Jin Y. Kim DDS, MPH, MS, FACDGDIA Director

W. Eric ParkDDS GDIA Mentor

Charles C. ParkDDS GDIA Mentor

Marco Tulio Alzaga VegaDDS GDIA Mentor

Course Faculty

2013 Friday - Monday

October 11 ~ 142014 Friday - MondayJanuary 31 ~ February 3May 23 ~ 26September 12 ~ 15November 21 ~ 24

What sets this course apart from others…

1. 1:1 instructor ratio - With qualified instructors and volunteer GDIA Metors we maintain a 1:1 ratio of instructors to student, if not more instructors than the trainee.

2. Amazing facility, materials, and equipment – we train at state-of-the-art private practice in Tijuana. Participants will find that the materials and equipment provided are better than many practices in the US!

3. You choose what cases to work on – Is your main interest sinus grafts? Or maybe advanced GBR? You review the cases, you propose a treatment plan, and your do the case under expert supervision! All cases are pre-screened by the instructors, and have been reviewed, and available for review ahead of time!!!

4. Safe and friendly surrounding – Based in central Tijuana, the clinic and the hotel facility is one of the safest in the city. The clinic is staffed by a number of clinicians who are also active with the local dental implant organizations. The program is run in conjunction to local non-profit organization, and is subsidized by the local health authority.

5. Most value for the tuition– with all of these features, you cannot find any other program that offers so much.

Course DescriptionThe Hands-on Live Patient Surgery course is an advance session that will cover Maxillary Sinus Augmentation, Guided Bone Regeneration (GBR), and Soft Tissues procedures. This program is open to clinicians with previous exposure to implant dentistry. Participants will receive 14 CE Units from the California Dental Board at the time of completion. All hands-on cases are selected and pre-screened by GDIA faculties before date of surgery. All surgical materials and instruments will be provided. Each participant is expected to see as many patients in the time allocated. This course will be held in Tijuana, Mexico and requires 3 nights stay. Participants are responsible for check-in at San Diego and transportation from San Diego to Tijuana will be provided. Lodging and meals will be provided in a safe and comfortable hotel facility.

2013 - 2014

Live-Patient Surgery Training Coursein Tijuana, Mexico

www.GlobalImplantTraining.comwww.liveimplantsurgery.com/Mexico.html

2014 Friday - Monday

January 31 ~ February 3May 23 ~ 26September 12 ~ 15November 21 ~ 24

25 CEU

2013Friday - Monday

October 11 ~ 14

●The course runs from Friday afternoon to Monday afternoon.●3-night stay in Mexico is required. Don’t forget to pack your passport!

4p_Event-Mexico04-2014-spread_copy.indd 4-1 09/10/2013 pm 5:16:54

Grand hotel tijuanawww.grandhoteltj.com

San Diego International Airport

Registration form

*Refunds are granted only if a written cancellation notification is received at least 21 days before the course. 50% of the tuition minus processing fee will be refunded if cancellation occurs within 14 days before this course. No refund is granted afterwards. A $75 fee is withheld for processing. For additional registrations, xerox and send.

CourseTuition

Qty. SubtotalMember Non - Member

Membership $695

Live-Patient Surgery Training Course 25 CEU

$9,500 $10,500

Grand Total:

Applicant’s Information:

Doctor Name DDS DMD

Office Address

City State Zip

Office Phone Fax

Cell Phone e-Mail

Licensed in State License #

Specialty (if applicable)

Copy of current state dental license attached

Copy of current dental malpractice policy attached

Level of Clinical Experience:

Extensive=20+ cases, Moderate= 10-20 case, Limited=less than 10 cases, None=0

Dental surgery in general [ ] extensive [ ] moderate [ ] limited [ ] none

Dental implant surgery [ ] extensive [ ] moderate [ ] limited [ ] none

Soft tissue surgery [ ] extensive [ ] moderate [ ] limited [ ] none

Sinus grating procedures [ ] extensive [ ] moderate [ ] limited [ ] none

Advanced grafting procedures [ ] extensive [ ] moderate [ ] limited [ ] none

CE courses taken in past 12 months [ ] 50+ hrs [ ] 25-50 hrs [ ]10-25 hrs [ ]<10 hrs

Describe formal implant training (institute, instructor, when taken, length of time etc)

Implant

system(s) familiar with

I understand that the program supplies me with a number of clinical cases that are suitable for learning purposes

of the participants

I understand that due to the nature of clinical case load, the cases will be distributed to each participants

depending on the availability of cases, experience level of each participants, and type of procedure being rendered.

I understand that summary of cases (photographs, clinical images, radiographs, health history, models)will be

available for review, prior to the first clinical session

I understand that I will be operating clinically under the auspices of Global Dental Implant Academy and Centro De

Odontologia Especializada. I also understand that provisional licensure is granted to the program by the local health

authorities.

I agree as a health care professional to practice in the safest, and the most sound method possible and as in the

Hippocratic Oath, “do no harm.”

EXPENSES

The tuition of this program will be $10,500

As I am a member of GDIA, my tuition for this program will be $9,500

I agree to pay 50% of the tuition in order to secure my spot in the program, at least 15 days before the program date.

I understand that the travel to and from San Diego International airport is my responsibility. I also understand that

travel from San Diego International Airport to the hotel in Tijuana, and to and fro the clinic is provided by GDIA.

I understand that the hotel accommodation and all meals are included in the tuition.

Method of Payment Please make check payable to Global Dental Implant Academy [GDIA] and mail to:

5455 Wilshire Blvd Ste. 950, L.A., CA 90036 Office: (323) 617-4141 Fax: (323) 617-4145

Total Credit Change: $_________

Card Type: VISA MASTER AMEX

Credit Card No.: _______________________________________________________

Exp. Date : __________ Billing Zip Code : ______________________________

Signature : ________________________ Date : __________

Day 2 Saturday 8:00AM Breakfast 8:00AM - 9:00AM Case Planning Session 9:00AM -12:00PM Surgery Session 1 12:00PM - 1:00PM Lunch 1:00PM - 5:00PM Surgery Session 2 5:00PM - 6:00PM Back to hotel 6:00PM - 8:00PM Dinner & Surgery case review

Day 3 Sunday 8:00AM Breakfast 8:00AM - 9:00AM Case Planning Session 9:00AM - 12:00PM Surgery Session 3 12:00PM - 1:00PM Lunch 1:00PM - 5:00PM Surgery Session 4 5:00PM - 6:00PM Back to hotel 6:00PM - 8:00PM Dinner & Surgery case review

Day 4 Monday 8:00AM Breakfast 8:00AM - 9:00AM Case Planning Session 9:00AM -12:00PM Surgery Session 5 12:00PM - 1:00PM Lunch 1:00PM - 2:00PM Review of Cases 2:00PM - 4:00PM Course Completion Ceremony 4:00PM - Check out of hotel and transport to SD airport

Day 1 Friday 5:00PM Meet at San Diego International Airport. Travel across the border to Tijuana via transportation provided by GDIA 7:00PM Check-in at hotel, and orientation begins after dinner

Course Schedule

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