Please use the following form to register for today's event. Make sure to complete all the required fields below. Event Information Select your registration type: * On-Site General Registration - $35Medical Student, Resident, Fellow - $35*Staff Proof of Enrollment Required * Proof of active enrollment in a medical school, residency, or fellowship program enrollment, is required. Please select how you will be providing proof of enrollment. Letter or email from the program director Show the current listing on the program's website directory STAFF ONLY: * I will be claiming the following credits... * Selecting a credit type below is NOT a guarantee of eligibility. Credit availability is subject to the registrant's eligibility - certain credits are only available with the proper credentials. Attendance credits will be awarded by default if the registrant is not eligible for their credit preference. Attendance Credit CME Credits (AMA PRA Category 1) To be eligible for CME Credits you must be a licensed: Physician, Physician in Training, Physician Assistant, or Nurse Practitioner. You must provide your license number. Registrant Information Do you have an iLearn Account? * Yes No Unsure An account is required in order to properly record your registration. By submitting this registration form you are agreeing to create a free account in our learning platform.You will receive an email to the address provided above with instructions on how to create an account.Your registration will be processed using the email address provided above in the next 2-3 business days, and you will receive a notification via email with further instructions. If we are able to locate your account we will process your registration manually and tie it to your account within the next 48 business hours. You will receive an email confirmation once you are registered to the e-mail address associated with your iLearn account.We will contact you at the email/phone number provided if your account cannot be located. Name * Phone * E-mail * Select Profession * Physician Physician-in-Training (Resident/Fellow) Physician Assistant Medical Student Nurse Nurse Practitioner Pharmacist Psychologist Radiology Technologist Therapist (OT/PT, Speech/RT) Technician Other License Number * Leave this field blank
