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Please check the box below to confirm you have read the terms and conditions for the course, certification exam, and/or manual you desire. Click here to view a new window with the "Terms and Conditions Page"
All of our courses/testing examinations intend to fully comply with the ADA. If you need any special assistance please check the box below and indicate the best phone number for an event staff coordinator to contact you. To ensure proper accommodations are made please ensure requests are in 3 weeks prior to event.
Phone:
Ext:
REGISTRATION FORM
Sclerotherapy Training in Medical Center
Personal Information
* Name:
* Address:
* City:
* State:
* Zip:
*Email:
Phone 1:
Degree:
License Information
State of License:
License Number:
Specialty:
Americans with Disability Act
Terms
Questions or Concerns Contact:
305-740-4444
Years in Practice :
Two Days Private Sclerotherapy Training Seminar
Open to all health care professions MD, RN, DPM, PA, NP
Date Requested
Specialized in Sclerotherapy Training
CopaVin
The true experts, 30 yrs of perfoming Sclerotherapy
Please give us a from to dates / weeks that will work for you, Monday thru Friday , we will verify availability and will contact you, you with confirmation, Number Please note that only after you get a confirmation number is that you should obtain the transportation and accommodation that you may require
From Date / Month /Yr
To Date / Month /Yr
Note :
Now Click here to go to payment
Note:
Two Days, in the medical Center with the Doctors and RN that perform Sclerotherapy only 1600
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Questions or Concerns Contact:
305-740-4444
Next Seminar Dates will be held on ( select your date)
A.- Friday and Saturday of third (3 ) week of this month .
B.- Then the next seminar will be held the Second (2) week of the following month , also on Friday and Saturday.
