Seminar Confirmation

Please take a moment to finalize your seminar registration by completing the form below.

  • Seminar Details

  • Name Badge

    The following information will be used verbatim on your name badge. Please make sure that the information entered is EXACTLY as you wish for it to read on your name badge.
  • Please list any designations, credentials, or other appellation earned that you would like to appear after your name. i.e., MFA, CMSR, PhD, MD, etc.
  • Contact Information

  • Employment Details

  • Please indicate the number of beds, practicing physicians, or any other measurements your organization has.
  • Please check all that apply.
  • Continued Education

  • How Did You Hear About Us?

    Please take a moment to help us target our marketing efforts.
  • Thank you so much for taking the time to help us make this seminar a fantastic experience for YOU!

Reminder: After submitting this confirmation form, please return to the email that brought you here and click the link to initiate processing.