Basic Modules

No Pain Clinic Program

Registration Form
Name

First Name Middle Name Last Name
Clinic Name
Clinic Name
Address

Street Address

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City State / Province

Postal / Zip Code Country
E-mail
Mobile Number

Area Code Phone Number
Phone Number

Area Code Phone Number
Work Number

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Type a question
Educations of Dental School
Spoken Language
Experience with Implantology

Yes No
Check the box of the Module you want to register in the following table:
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Module 4: The Basic of Dental Implants Radiology and Planning $ 1,000.00

Module 5: Basic Surgical Procedures and Implantation in the Daily Practice (Part I) $ 1,000.00

Module 7: Basic Prosthetic Aspects in Dental Implantology (Part I) $ 1,000.00

Module 9: Basic Implant Periodontics (Hard and Soft Tissue Management) (Part I) $ 1,000.00

Module 12 : Treating Severely Atrophied Maxilla (Sinus Lifting) $ 500.00

Module 13 : Management of Severely Atrophied Mandible including Inferior Alveolar Nerve Transpositioning $ 500.00

Module 14 : Narrow Ridge correction prior to Dental Implants insertion (Ridge Splitting) $ 500.00

Module 15 : Advanced Digital workflow from scanning to digital impression and Digital Smile Design, to Surgical Guide and CBCT Planning $ 1,000.00

Module 16 : Infection Control Strategies in the Dental Clinic $ 1,000.00

Module 17 : Live Advanced Special Cadaver Course and/or Live OP $ 1,500.00

Total $ 0.00
- I am submitting my binding application concerning the participation in the above mentioned education which will lead to No Pain Clinic Certificate.
- I am aware that i must have a Piezotome Machine (Sponsored Education by Acteon) at my Clinic in order to have the No Pain Clinic Certificate.
- The legal and Contractual Regulations detailed in the Program Brochure become the basis of this Application and as such are an integral part of the contract. With regard to course topics, the issues detailed in the program brochure are considered as agreed between the concerned parties. However, it must be noted again that changes and amendments beyond the scope shown there in can be made at the sole discretion of the Organizers.
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No Pain Clinic Program