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Laser Certification Training
2012 Certification Dates
Registration Form

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Laser Certification Training Registration Form

Family Name Given Name(s) Designation(s)

Clinic Name
Clinic Address
City
Province/State
Postal/Zip Code
Country
Contact Phone Number
Contact Email Address
Special Dietary Requirements

Training Date/Location

I understand that training is: (please select one)
$995 - Includes all course materials, Dr. F. Kahn's three textbooks, structured
        classroom presentations and hands-on clinical exposure.
$750* - Includes course materials, structured classroom presentations and
        hands-on clinical exposure.

Important Information
A certificate is presented to all healthcare professionals upon satisfactory completion of this course. Lunch and refreshments are provided during the training.

Registration fee waived for participants purchasing BioFlex Systems.

Registration is not confirmed until payment is received.

I agree to the terms


Credit Card Type
Card Number
Card Expiry
3 Digit Security #
Name on Card

Word Verification
Submission
Meditech Rehabilitaion Centers Toll free # 888-557-4004
Tel: (416) 251-1055
Email: info@bioflexlaser.com
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