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Strategies for Working with Chronically Ill
Patients and Their Families
 

Wednesday, November 5, 2003
12:15 - 7:45 p.m.
Holiday Inn, Newton
399 Grove Street
Newton, MA
 

REGISTRATION
  General Registration Fee. $75.
Special Fee for Tufts Health Plan Employees and Network Providers. $50

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.
 
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. THCI will confirm registration upon receipt of payment.
       
  $75 General Registration Fee
$50 Special Registration Fee for Tufts Health Plan Employees and Providers
       
  Registrant Information    
  First Name Last Name  
 
  Title Department  
 
  Organization    
 
  Address    
 
 
  City State Zip
 
  Phone Fax  
   
  E-mail    
 
     
  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    
 

Cancellations by October 29 will be refunded, less a $25 administrative fee per registrant. Registrants who do not cancel by October 29 and do not attend are responsible for their full registration fee.

 
  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.
 

  © 2003 Tufts Health Care Institute | Boston, MA | (617) 636-1000