2026 Staab Registration

Attendee Information

First Name*

Last Name*

Credentials*

AOA # (only for DO's)

EX: 012345

OK State License Number

EX: 1234; The Oklahoma State Board of Osteopathic Examiners requires the Osteopathic Founders Foundation to submit proof of your participation in any approved Proper Prescribing lectures. You must provide your Oklahoma State license number so that we may submit attendance records on your behalf.

Other Credentials, if applicable

EX: RN, APRN, NP, etc.

Specialty*

Contact Information

Home Mailing Address*

Physical Address

City*

State or Canadian Province*

Zip Code*

Cell Phone Number*

Primary Email Address*

Confirmation EmailTo be used for all program communication

Type of Email Address*

PersonalWork

Secondary Email Address (optional)

Program communication will also be sent to this email

Type of Email Address

PersonalWork

How did you first hear about this year's program?*

My Products*

IN-PERSONProper Prescribing included (Pricing available February 1, 2026 - April 2, 2026)

$350.00

VIRTUALProper Prescribing included (Pricing available February 1, 2026 - April 2, 2026)

$450.00

Retired Healthcare Provider (IN-PERSON ONLY)DO, MD, PA, NP, etc. (Pricing available December 15, 2025 - April 2, 2026)

$200.00

Proper Prescribing ONLY (VIRTUAL ONLY)This is only for the one-hour Proper Prescribing lecture (Pricing available December 15, 2025 - April 8, 2026)

$50.00

Total

$0.00

Credit Card

FIRST NAME ONLY, as you would prefer it to be on your Name Badge

EX: Bill, Sue, Tom, Mary, etc.

Communication Release
By submitting this registration, you consent to receive communications from the Osteopathic Founders Foundation at the address(es) provided in this form. These communications may include registration confirmations and symposium-specific updates. Your information will remain confidential and will not be shared with outside entities.

Photo Release
By submitting this registration, you grant the Osteopathic Founders Foundation permission to use and distribute your image or voice taken during these events and activities in future marketing photographs, videos, electronic reproductions, and audio recordings.

Refund Policy
Refunds will be issued for written cancellation requests received on or before March 13, 2026. A $50.00 administrative fee will be deducted from all refunds.

Registration Changes
Requests for registration changes must be submitted in writing on or before April 2, 2026. A $25.00 administrative fee will apply to all changes.

OFF Grievance Policy
The Osteopathic Founders Foundation is committed to providing educational programs that meet the needs of participants. Comments, questions, or complaints may be submitted in writing to:
Adrienne Kingsley, Education Coordinator
8801 S Yale Ave, Suite 400
Tulsa, OK 74137
Email: akingsley@osteopathicfounders.org

Please check below to agree to the policies outlined above.*

I agree

Attendee Registration

Credit Card