Event registration Payment confirmed NoYes Payment amount requested Line items Transaction ID Payment API response Event * First name — Middle initial — Last name * Middle initial Last name * Please enter names separately. Primary title * Primary affiliation * Twitter name (optional) Mailing address * City * State / Province / Region Postal code Country Email address * Work phone Mobile phone International phone Emergency contact name and phone number Register as * ...Member (requires login) | $175Virtual member (requires login) | $50Non-member | $80Student (requires login) | $120Public agency/foundation | $350Nonprofit PIO public relations | $425Other PIO public relations | $640VIP / sponsorExhibitor | $425AHCJ award recipient (current year)Conference fellow (current year)Health Performance fellow (current year)AHCJ drawing winner (current year)Core Topic leaderPitchFest editorAHCJ board memberMU J-school | $25 Requires AHCJ membership. Renew today if your membership expires on or before the last day of the event. Will you attend in person or online? I will attend in person.I will attend online. Will you be joining us for meals? No meals Thursday evening reception Friday breakfast Saturday breakfast Saturday awards luncheon Saturday evening reception Sunday breakfast Please note: If you RSVP for the Saturday awards luncheon, you will receive a ticket to present for admittance to the luncheon. Without your ticket, we cannot guarantee a seat or a meal.If your meal plans change, please let us know no later than one week prior to the event. Send any changes to susan@healthjournalism.org. Do you require a special diet? No special diet Vegetarian Vegan Gluten-free Please make dietary requests now. We cannot honor on-site requests. Do you have any food allergies that we need to accommodate? No food allergies Eggs Milk Wheat Soy Shellfish Fish Tree nuts Peanuts Other If other, please specify If you have food allergies, do you carry epinephrine and what is your own relief action plan? Exhibit reservation ID How did you hear about this event? AHCJ email message AHCJ website AHCJ newsletter Facebook Twitter LinkedIn Phone call Colleague Other Please specify Receive a one-time post-conference email from AHCJ with story tips and ideas gathered from some of our sponsors? Yes No Which nights will you be staying? None Tuesday night Wednesday night Thursday night Friday night Saturday night AHCJ will make your reservation for your entire length of stay at our special room rate and you will receive a confirmation directly from the hotel (you must provide an email address).If you reside more than 50 miles from the event hotel, AHCJ will pay for a number of nights determined by your registration category. The hotel will ask you for a credit card upon check-in to pay for any incidentals and additional room nights. Will you need us to provide assistance with travel costs? I will not need AHCJ to assist with travel costs. Will use airline travel credits from HJ20 (April 2020) Yes, within 50 miles of conference Yes, more than 50 miles from conference Does not include valet parking. What is your COVID-19 vaccination status? Fully vaccinated Unable to be vaccinated / not vaccinated Please provide evidence of COVID-19 vaccination, such as an image of your vaccination record card. Do you have a medical or religious exemption from receiving the vaccine? Yes -- I have a medical or religious exemption. No -- I do not have a medical or religious exemption. Medical or religious exemption I attest that I have a medical contraindication to COVID-19 vaccination or have genuine and sincerely held religious beliefs which are contrary to COVID-19 vaccination. I understand that as an unvaccinated person I must agree to wear a mask while indoors and in the conference areas. AHCJ is requiring vaccination of all eligible individuals or an attestation of medical or religious exemption in order to attend the Health Journalism conference in person. Please contact info@healthjournalism.org if you have any questions or concerns. COVID-19 safety information I understand my duty to self-monitor for signs and symptoms of COVID-19 (symptoms typically include fever, cough, and shortness of breath). I will contact AHCJ at info@healthjournalism.org and will not attend the conference if I begin to exhibit any symptoms of COVID-19 while traveling to Austin or on site in Austin. Please let us know your level of comfort with social contact. You will be able to update your preference when checking in on-site. Comfortable with hugs and handshakes Comfortable with fist bumps and maintaining some personal space Not comfortable with close contact; prefer to maintain social distancing Person ID Please enable JavaScript in your web browser and try again.