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| Department
of Radiology,
Caritas St. Elizabeth's Medical Center
Presents
Imaging Strategies in Primary Care Medicine |
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Friday,
October 10, 2003
7:45 a.m. - 4:30 p.m.
Boston Marriott Newton
2345 Commonwealth Avenue
Newton, MA
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REGISTRATION
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$125. Early Registration
(Deadline Friday, Sept. 5, 2003)
$175. Registration after Sept. 5, 2003
Registration deadline is October 3, 2003.
Payment is required at the time of registration. Registration
is not confirmed until payment is received. Registrations
are processed on a first-come, first-served basis.
Conference registration must be made through Tufts Health
Care Institute. Register by Sept. 5, 2003, and save
$50. |
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There are
four ways to register:
- To register online, fill
in the form below, then click "Submit Registration."
- To register by fax, fill
in the form below, then print and fax it to 617-636-0429
- To register by phone,
call 617-636-1000.
- To register by mail, fill
in the form below, then print and mail it to THCI,
136 Harrison Avenue, Boston, MA 02111.
Payment is required at the time
of registration. |
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$125 Early Registration (deadline 9/5/03)
$175 Regular Registration (after 9/5/03)
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Registrant Information |
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First
Name |
Last
Name |
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Title |
Department |
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Organization |
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Address |
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City |
State |
Zip |
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Phone |
Fax |
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E-mail |
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Practice
Specialty |
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Number
of physicians in your practice |
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How
did you learn about the conference? |
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Other source:
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Payment Preference |
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Check (Please
make payable to Tufts Health Care Institute.)
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Credit Card
(THCI will follow-up with you to receive your credit
card information.) |
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Send me an
invoice. |
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Cancellation/Refunds |
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Cancellation
of conference registration must be requested in writing
and postmarked or emailed (thci@thci.org)
no later than October 3, 2003. Refunds, less a $50 administrative
fee per registrant, will be issued. Cancellation/ refund
requests will not be granted after October 3, 2003.
Registrants who do not cancel by October 3 and do not
attend are responsible for the full registration fee.
There is no penalty for substituting
one attendee for another at any time. Registration
substitutions will be accepted with written notification
from the original registrant (via mail or email at
thci@thci.org)
In the unlikely event that Caritas Christi Health
Care, St. Elizabeth's Department of Radiology, and
THCI cancel the conference, registration fees will
be refunded.
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Please
press "Submit Registration" below to complete
the registration process.
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Note:
Some Internet Explorer users may be asked if they wish
to download an applet from Microsoft. Your choice will
not affect the proper functioning of this form. |
