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Registration Form - Injections Course 

Expanded Pain Management & Diagnostic Injections Course: 
Saturday, February 25, 2012 from 9 a.m. to 1 p.m.
at American Family Dentistry Training Center

Four hours of continuing education available.
Lunch will be provided.

This course is a Lecture and Hands-On Injection Course for physicians and dentists.  Give yourself the edge in predictable pain control and give your patients the benefit of precision diagnostic injections to correctly diagnose and successfully manage their pain.

FOUR hours of Continuing Education for this AFD Training Center Event
This CE activity has been planned and implemented in accordance with the standards of the ADA Continuing Education Recognition Program (ADA CERP) through joint efforts between Big Sky Seminars and Augusta Family Dentistry.

Big Sky Seminars is an ADA CERP recognized provider.

Big Sky Seminars designates the activity for four (4) hours continuing education credit.

Name:
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Emergency Contact (for use only while you are on-site at this meeting):
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Payment Options
I will mail a check to AFDTC for the non-refundable course cost of $150.00 by February 20 2012. (Payments should be mailed to AFDTC Attn: Jaime Simpson 401 State Street Augusta KS 67010.)
I will pay the non-refundable course cost of $150.00 via PayPal. (See PayPal button under "Online Payment" tab.)
 
 
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American Family Dentistry Training Center, Inc.
401 State Street
Augusta, KS 67010
Phone: 316.775.2482


through Big Sky Seminars