Name
*
First Name
Last Name
Professional Classification
*
Please Select
MD
DO
MBBS
DDS
PharmD
RN
Nurse Practitioner
Physician Assistant
Physical Therapist
Occupational Therapist
MPH
Undergraduate Student
Medical Student
Dental Student
Nursing Student
Pharmacy Student
Nurse Practitioner Student
Physician Assistant Student
PT Student
OT Student
Public Health Student
Other
Email
*
example@example.com
Alternative Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work Information: Job Title
*
Company
*
How did you hear about the HHC?
*
Please Select
Email Announcement from INMED
Google
Facebook
LinkedIn
Other Online search
Invitation from a Friend or Colleague
Announcement from my school
Announcement from my employer
I am a past INMED participant
Would you like information on presenting a poster at the conference?
*
Yes
No
Registration Options
*
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( X )
2025 HHC Registration
$
200.00
Quantity
Please select your preference for dinner Thursday night (Select one)
*
Vegetarian
Chicken
Beef
I cannot attend the Thursday night dinner
If you have any food allergies or dietary restrictions, please share them here. We cannot accommodate all dietary preferences but will use the information gathered when selecting options for catering. Thank you for understanding.
Hands-On Skills (Rank Preferences)
To assist us in preparing for the hands-on skills sessions please rank the activity you would like to attend. There is a limited number of attendees per session.
Please rank your preferences for the following Hands-on Skill Session:
*
First Choice
Second Choice
Third Choice
Vision Solutions in 10 minutes
Excision of Dermatological Lesions
Cervical Cancer Screening
Airway Management
Please rank your preferences for the following Hands-on Skill Session:
*
First Choice
Second Choice
Third Choice
Ultrasound Paracentesis & Thoracentesis Simulation
Suturing
Splinting and Casting
Payment
If selecting PayPay, please use guest check out. You DO NOT need a PayPal account to pay.
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