Ayurveda Comes West

Course Registration & Online Payment

Use this form if you wish to pay for this course using a credit or debit card.
WANT TO PAY WITH A CHECK OR MONEY ORDER INSTEAD? CLICK HERE!
This course is open to veterinarians primarily and is limited to 25 people.

If you are a non-veterinarian interested in taking this course, please email Dr. Dohmen at drlaurie@purplemoonherbstudies.com prior to registering for this course.
Attendee Name

First NameLast Name
Address

Street Address

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Postal / Zip Code
Email
example@example.com
Cell Phone Number (no landlines please)
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Person

First NameLast Name
Emergency Contact Person's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
PLEASE MAKE SURE ALL THE REQUIRED INFORMATION BELOW IS CORRECT. SUBMITTING INCORRECT INFORMATION MAY RESULT IN YOUR NOT RECEIVING YOUR CE CREDITS.
Please list your Veterinary License Number(s), and the State(s) where the License(s) are valid.
Type of License
Graduation Year & School
Other Training
How Did You Hear About Us?

Ayurveda Comes West

Full payment for our 2027 Ayurveda Comes West Course

$425.00 Quantity
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PLEASE BE SURE TO ENTER YOUR CREDIT/DEBIT CARD INFORMATION ABOVE PRIOR TO CLICKING THE SUBMIT BUTTON.
REFUND POLICY: A $50 PROCESSING FEE WILL BE APPLIED TO ALL REFUNDS ISSUED

PLEASE NOTE THAT NO REFUNDS WILL BE ISSUED AFTER JANUARY 20th 2027.
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Course Registration & Online Payment