Hepatitis C Conference Registration

Dinner Conference Registration

Thank you for your interest in the upcoming continuing education training entitled Hepatitis C: New Tests, New Drugs, and New Recommendations; with Naloxone: Preventing Opioid Overdose in the Community, scheduled for Monday, November 13, 2017, at the Beef Haus, North Main Street, Wellsville, New York. Pre-registration is required to attend this event no later than November 3, 2017, by completing the information below.

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Name *

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Last

Organization *

Address *

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City

State

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Title *

Phone Number *

Fax Number *

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Confirmation Notices will be sent via email.

Dietary Restrictions *

Payment

Conference Registration Fee *

Individual $20.00

Form of Payment *

Please Send Invoice Check Purchase Order

All cancellations must be received five (5) business days in advance of the event. If notification is not received and/or a substitute is not available to take your place, you will be billed for the full amount.

ADA Accommodations and Customer Support

If you require any support for your ADA needs, or have any concerns or questions, please contact us by email at least 3 weeks prior to the event at evansh@ardentnetwork.org or by phone at 585-593-5223 ext. 1011.

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