Zoom Invite Request
You will receive your Zoom Invite link one week before the Zoom.
Name
First Name
Last Name
Email
example@example.com
Mobile Phone Number Suggested
Please enter a valid phone number.
Practice Phone Number
Please enter a valid phone number.
Practice Name
Practice Address
Practice City
Practice State
Practice Zip
Direct office phone number. Include ext.
How many attendees? You can approximate. Each attendee should have a patient to cast.
Please pick requested Zoom date and time. All times are eastern standard time zone
Please Select
Tuesday June 7th 8PM EST (5pm Pacific)
Thursday June 9th 4PM EST (1pm Pacific)
Tuesday Jun 14th 3PM EST (12noon Pacific)
Please verify that you are human
*
Submit
Should be Empty: