Search our website
Contact Us
Downloads
Online Courses & Assessments
 
 
 

 

Department of Radiology,
St. Elizabeth's Medical Center

Present
s

Imaging Strategies in Primary Care Medicine

 
Friday, October 18th, 2002
8 a.m. - 5:30 p.m.
Hyatt Regency Cambridge
575 Memorial Drive, Cambridge, MA
 

Registration Form

  Conference Registration
 
  • 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, 75 Kneeland Street, 11th Floor, Boston, MA 02111.

Payment is required at the time of registration.

  (Select one)    
  $150 per person    
       
  Registrant Information    
  First Name Last Name  
 
  Title Department  
 
  Organization    
 
  Address    
 
 
  City State Zip
 
  Phone Fax  
   
  E-mail    
 
       
  Practice Specialty
     
   
  Number of physicians in your practice
     
  How did you learn about the conference?
  Other source:    
   
       
  Payment Preference    
  Check (Please make payable to Tufts Health Care Institute.)
  Credit Card (THCI will follow-up with you to receive your credit card information.)
  Send me an invoice.
   
  Cancellation/Refunds    
  Cancellation of conference registration must be requested in writing and postmarked or emailed (tmci@tufts-health.com) no later than October 4, 2002. Refunds, less a $50 administrative fee per registrant, will be issued. Cancellation/ refund requests will not be granted after October 4, 2002. Registrants who do not cancel by October 4 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). 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.
 
  Please press "Submit Registration" below to complete the registration process.
   
       
  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.
 

  © 2002 Tufts Health Care Institute | Boston, MA | (617) 636-1000