March 16, 2026 Day at the Capitol: Stop the Bleed Demonstration & Legislative Lunch Registration
Last Registration Day - March 6, 2026
Attendee Information
Please sign up so we can: Confirm your legislative district, pair you with the correct representative, and finalize lunch catering counts. Thank you!
Your Name
Mr.
Mrs.
Dr.
Nurse
Prefix
First Name
Last Name
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will you be attending lunch?
Yes
No
If you are interested in becoming Stop The Bleed Certified, what training session time would you like to attend?
9am - 10am
10am - 11am
11am - 12pm
12pm - 1pm
I will get certified another time.
I am already certified in Stop the Bleed and I am interested in teaching a class session.
Submit
Contact Us:
Phone: 602-489-1564
Email: surgeons@azmed.org
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