• HCMS Business Expo Registration Form

    Spring Expo - Saturday, April 8, 2017, 8:30 am - 4:30 pm

    Are you a member of HCMS? 

               
     If "No", cost per CME credit to non-member physicians is $30   

    I am a (choose one): 

        

    First Name: 

        

    Middle Initial 

        

    Last Name: 

        

    Practice Name: 

        

    Email Address:  

     
      a parking pass will be emailed to you the week of the event

    Phone: 

      Ext:    

       

     
    Free CME Seminar
    you plan to attend: 

    Choose all that apply 

      

        

      

    *TMLT policy holders who complete this program may earn a 3 percent discount that will be applied to their next eligible policy period.  

      

     

    Lunch and Learn
    Free CME Seminar:
     

     


    Are you bringing a
    guest?
    If yes, please list
    guest names: 

     


    1.  

    2.    

    3.    

     

     

    How did you hear
    about the Expo? 

    Choose all that apply

     
     
                                  
      
    Comments: