Symposium Registration - Step 1

Student / Fellow Registration

Degree(s): MD MBBS DO PhD - Other

Last Name*

First Name*

M.I.

Address*

City*

State**

Zip* (0 if none)

Country*

Affiliation

Office Phone*:

Home Phone:

Fax Phone:

(Please include country and city codes: xxx-xxx-xxxx)

Email*

(For confirmation of registration and payment - name@domain.com)

Specialty or Area of Practice:

 

*Fields with *asterisk are required.
**Fields with **asterisk are required in the United States.

 

OPTIONAL INDUSTRY SESSIONS

Product Theatre sessions require RSVP's. Please indicate below if you plan to attend any of
Saturday's sessions. (All are non-CME)

Breakfast Session Product Theatre (non-CME). Hot breakfast will be provided to those that
attend. This session requires a RSVP. Please indicate below if you plan to attend.

YES, I will attend the Product Theatre Breakfast Session
              XARELTO to Treat Thrombosis and Reduce Thrombotic Risk for Patients with
              Non-Valvular Atrial Fibrillation and Heart Failure

              Anil Bhandari, MD
              supported by Janssen Pharmaceuticals, Inc.
              7:00 am on Saturday, April 22 (non-CME)

Lunch Session Product Theatre (non-CME). Lunch will be provided to those that attend. This
session requires a RSVP. Please indicate below if you plan to attend.

YES, I will attend the Product Theatre Lunch Session
              Putting Guidelines into Practice: New Recommendations for Optimal
              Treatment of Heart Failure with Reduced Ejection Fraction (HFrEF)

              Barry Greenberg, MD
              supported by Novartis Pharmaceuticals Corporation
              12:10 pm on Saturday, April 22 (non-CME)

Cocktail Reception/Presentation (non-CME). This session requires a RSVP.
Please indicate below if you plan to attend.

YES, I will attend the Cocktail Reception/Presentation
              Repatha®(evolocumab): A Focused Clinical Review
              Pam R. Taub, MD, FACC
              supported by Amgen
              6:00 pm on Saturday, April 22 (non-CME)

 

REGISTRATION FEES

$50

1. Early-Bird On or before February 27, 2017

$50

2. Pre-Registration Feb. 28, 2017 - Apr. 3, 2017

$50

3. Registration After April 3 and On-site

Only Visa, Mastercard, Amex and Discover accepted.
Mail in Option also available.

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