ATOPP Live Peak Exchange Confirmation Form

Name*

First NameLast Name

Email*

example@example.com

By checking this box, I am opting in to share my email address with companies that are participating in the program.By checking this box, I am opting out of sharing my email address with companies that are participating in the program.

Thank you for agreeing to participate in the Peak Exchange Reverse Expo as one of our Pharmacy and Administration Leadership participants or Clinical Thought Leaders (PALs/CTLs). The reverse expo will take place on July 15-17, 2026 in conjunction with the 2026 ATOPP Summit at the Gaylord National Resort and Convention Center. This form provides additional information regarding your participation.

Sessions:

Wednesday, July 15
2:30 - 4:30 pm ET

Thursday, July 16
7:15am - 9:15 am ET

Thursday, July 16
4:15 - 6:15 pm ET

Friday, July 17
7:15am - 9:15 am ET

Gaylord National Resort and Convention Center
201 Waterford Street
Oxon Hill, MD 20745

Please give order of preference. Click & drag each option to your desired position: 1st, 2nd, 3rd or 4th preferred slot.*

Registration and Travel Details

As a participant in the Peak Exchange, you will receive complimentary full conference registration to the 2026 ATOPP Summit. After you complete this form, a discount code will be emailed to you. This code will waive your fee when you register for the meeting at atoppsummit.com. In addition to a waived registration fee, you will also receive limited travel expense reimbursement consisting of airfare (up to $500), ground transportation to and from the airport (up to $150), and up to 2 nights hotel stay. You may decline this offer.

Please sign the participant agreement (Appendix I) below. Please email peakexchange@cesynergy.com with any additional questions or comments regarding the contents of this letter. A registration agreement that discusses the full terms of this event will be sent to you via email for completion.

Thank you for your participation in the 2026 Peak Exchange. We look forward to seeing you in July in National Harbor!

Appendix I

Participant Confirmation

I, Name* , have reviewed the information in this letter and agree to participate in the Peak Exchange Reverse Expo, under the terms stated scheduled for July 15-17, 2026 at Gaylord National Resort and Convention Center

Name (including credentials):Name*
Title:Title*
Institution: Institution*

Signature*

Date*

Date