TOMF - Registration

CME

Registration

Continuing Medical Education
Online Registration Form
17th Annual Southwestern Conference on Medicine
May 1- 4, 2008
Westin La Paloma Resort and Spa

Please note:

Only use this form if you intend to register online. When you click "Submit and Pay" you will be directed to a secure site to enter payment information.

Seating is limited for certain functions. Registrations for those functions will be accepted on a first come-basis.

If you have any problems, please go to our printable registration page to fax or mail the form.

First Name:

Middle Initial:

Last Name:

Address:

Address
(line 2):

City:

State/Province:

Zip or Postal Code:

Country:

Day Phone Number:

Evening Phone:

E-mail address:

Please note: The above address may be published in the Conference syllabus.

Meal Functions

Please indicate which meal functions you will/will not attend:
Note: Each conference participant may bring ONE guest to the Friday reception dinner.
All other meal functions are for participants only.

Vegetarian Meals
YesNo

Thursday	Friday	Saturday	Sunday
Breakfast YesNo	Breakfast YesNo	Breakfast YesNo	Breakfast YesNo
Luncheon Pharm. Update on “Hypertension” (No CME) YesNo	Luncheon (In Exhibitor Hall) No CME YesNo
	Reception/ Dinner YesYes, with guestNo

Professional Degrees:

DOPA-C
MDNP
PANP-C
OtherRN

Status:

ActiveRetired
FellowResident

Additional Degrees, Credentials, and Designations

Other

AOA Number

Specialty

Optional Workshops

Joint InjectionsOMT - Back Pain

Please feel free to leave us any comments or tell us about any special needs

Information:

Additional Questions?

Email us at cme@tomf.org

Tucson Osteopathic Medical Foundation
c/o Precision Meetings & Events, Inc.
301 N. Fairfax Street
Suite 104
Alexandria, VA 22314

(877) 739-4480 or (703) 739-4480
FAX (703) 739-4481

We hope this will serve as a resource guide to assist you, the physician, in your commitment to professional medical education. Individual conference brochures are mailed two to three months prior to each conference. These brochures include complete information regarding conference objectives, agendas, registration information, etc.

	CME
	CALENDAR
	ONLINE REGISTRATION
	PRINTABLE REGISTRATION
	SCHOLARSHIPS

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