Registration Form | 2025 Concierge Medicine Forum
October 16-18, 2025
Forsyth Conference Center | Located Near Lanier Technical College | Physical Address: 3410 Ronald Reagan Blvd, Cumming, GA 30041 | Closest Airport: ATL | Please note, walk-in/up-registration is not permitted. This is a ticketed event(s). Pre-registration is required for all sessions, workshops, etc, in advance. Thank you!
Ticket Options
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3-Day All Access Badge
Oct 16-18, 2025 (Includes One Thurs Workshop + Main Conference Fri-Sat)
$
399.95
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2-Day All Access Badge
Oct 17-18, 2025 (Includes Main Conference Fri-Sat Only)
$
359.95
Seats
How many (total) your group?
*
Please Select
Solo
Group (2+)
Please note, if you are registering a group (2+), you understand you are acting on their behalf (i.e. "Signatory") and accepting all “Conference Participant Terms and Conditions”, including “Refund Policy”, “Waivers and Releases”, etc. outlined below on their behalf as well. Thank you.
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Name of Conference Participant #1 (or Primary Contact For Groups)
*
Prefix
First Name
Last Name
Which event(s) is Participant #1 attending? (NOTE: 2-DAY MAIN Conference Badges DO NOT include access to workshops. To attend workshop, you must purchase a 3-day pass. One workshop per person/badge; For 3-day badges, please do not select both workshops as they run concurrently on the same time and day; recordings not available). Thank you!
WORKSHOP: "Membership Medicine 101" (Thursday, Oct 16 9am-5pm ET)
WORKSHOP: "Marketing My Practice" (Thursday, Oct 16 9am-5pm ET)
2-Day Main Conference (All Sessions/Breakouts; Oct 17-18)
Conference Participant #2
First Name
Last Name
Which event(s) is Participant #2 attending? (NOTE: 2-DAY MAIN Conference Badges DO NOT include access to workshops. To attend workshop, you must purchase a 3-day pass. One workshop per person/badge; For 3-day badges, please do not select both workshops as they run concurrently on the same time and day; recordings not available). Thank you!
WORKSHOP: "Membership Medicine 101" (Thursday, Oct 16 9am-5pm ET)
WORKSHOP: "Marketing My Practice" (Thursday, Oct 16 9am-5pm ET)
2-Day Main Conference (All Sessions/Breakouts; Oct 17-18)
Conference Participant #3
First Name
Last Name
Which event(s) is Participant #3 attending? (NOTE: 2-DAY MAIN Conference Badges DO NOT include access to workshops. To attend workshop, you must purchase a 3-day pass. One workshop per person/badge; For 3-day badges, please do not select both workshops as they run concurrently on the same time and day; recordings not available). Thank you!
WORKSHOP: "Membership Medicine 101" (Thursday, Oct 16 9am-5pm ET)
WORKSHOP: "Marketing My Practice" (Thursday, Oct 16 9am-5pm ET)
2-Day Main Conference (All Sessions/Breakouts; Oct 17-18)
Conference Participant #4
First Name
Last Name
Which event(s) is Participant #4 attending? (NOTE: 2-DAY MAIN Conference Badges DO NOT include access to workshops. To attend workshop, you must purchase a 3-day pass. One workshop per person/badge; For 3-day badges, please do not select both workshops as they run concurrently on the same time and day; recordings not available). Thank you!
WORKSHOP: "Membership Medicine 101" (Thursday, Oct 16 9am-5pm ET)
WORKSHOP: "Marketing My Practice" (Thursday, Oct 16 9am-5pm ET)
2-Day Main Conference (All Sessions/Breakouts; Oct 17-18)
Conference Participant #5
First Name
Last Name
Which event(s) is Participant #5 attending? (NOTE: 2-DAY MAIN Conference Badges DO NOT include access to workshops. To attend workshop, you must purchase a 3-day pass. One workshop per person/badge; For 3-day badges, please do not select both workshops as they run concurrently on the same time and day; recordings not available). Thank you!
WORKSHOP: "Membership Medicine 101" (Thursday, Oct 16 9am-5pm ET)
WORKSHOP: "Marketing My Practice" (Thursday, Oct 16 9am-5pm ET)
2-Day Main Conference (All Sessions/Breakouts; Oct 17-18)
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Practice, Organization or Company Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
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Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
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Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
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Palau
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Panama
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Peru
Philippines
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Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
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Russia
Rwanda
Saint Barthelemy
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Samoa
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eSwatini
Sweden
Switzerland
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Vatican City
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Other
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Office Phone Number
*
Please enter a valid phone number.
Permission to Share Email with Attendees & Sponsors: If left unmarked (below), only your Full Name, Tel, and Address used at registration will be shared with participants and Sponsors. Thank you.
Email Address
*
example@example.com
Practice or Business Web Site Address
If completed, this web site address will be shared with Attendees and Sponsors At Conclusion of event. If left blank, it will not be shared.
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What Topics Are You Wanting To Learn About Most? Or, what is a solution or answer you hope to find at CMF this year?
Which Category Describes You?
*
Please Select
I'm A Physician Curious About This
I'm A Physician's Spouse
I Work In The Practice
I Am A Concierge Doctor/Practice
I'm With A Business In Healthcare
How did you hear about this conference?
(ie. Peer; Email; Postcard; LinkedIn; Facebook; Etc.)
Who on your team is attending CMF that you consider a hero? Please tell us their first and last name and why you admire them.
Example: Beth or Eddie; Because they ... ""
What would you request if you could have a (doable) wish granted at CMF?
Examples Include: A New Book Title You've Been Wanting To Read; A Sleep Mask; A New Stethoscope; or, A Cupcake From A Great Bakery!
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Conference Participant Terms & Conditions Accepted
*
Meal Considerations (Note: We will do our best to accommodate but can make no promises as catering events/conferences have a broad menu. Please read & agree to the Food Allergy Notice & Waiver in Your Registration Terms & Conditions below. Thank you.
*
Please Select
"I eat everything."
Pregnant or Nursing
Gluten Free
Vegetarian
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