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Meeting Registration Form
Please enter the attendee information in the required fields below.
Email Address
*
First Name
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中间的初始
Last Name
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Profession
Physician
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Specialty
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Registration Fee
Categories not listed (including corporate attendees) may register by phone at 1-877-307-5225 ext. 219 or ext. 476 (Mon-Fri 9-5 ET).
Select your registration category:
*
Please select a registration category!
Select
Physician
Resident/Student
* Please select a registration type!
Physician Registration - $300
Resident/Student Registration - $90
*Residents/students must submit a letter of verification at time of registration by emailing
registration@HealioLive.com
.
How did you hear about the meeting?
(select all that apply)
Brochure
Letter
Postcard
Email
Healio
Internet Search
Word of Mouth/Colleague
Phone
Other
By processing this registration, I understand and agree to the following:
I have read and accepted the Terms & Conditions outlined in the
Privacy Policy
as it pertains to the information we collect for registration, information collected while using our site, and the usage of cookies on this website.
I agree the
Wyanoke Group
may keep me informed with emails containing meeting updates and related information.
Requests for refunds must be submitted in writing to
registration@HealioLIVE.com
by June 28, 2021. There will be a service charge retained for all refund requests – $75 for physicians and $25 for all other categories. Requests received after this date will be ineligible for refunds.
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