WF NCORP Research Base Annual Meeting Registration

 Thursday, October 15th  

 Licensed Acupuncturists Only*

 

   

 * THERAPY MATERIALS WILL BE MAILED 2-3 WEEKS PRIOR TO THE MEETING.

 

    

Friday, October 16th  

              

Number Attending Reception:

 

Saturday, October 17th    

              

 


 

Name*

   

Job Title

   

Specialty

   

Credentials*

   

Last 4 Digits of SS#*

   

Business Address

City*

   

State*

   

Zip*

   

Business Phone *

   

Fax

   

E-mail*

   

Confirm E-mail*

   

NCORP Affiliation*  

   

Guest Names

   

Vegetarian Meals Preferred

            

   

   

 

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Quick Reference

Research Base

Fax 336-716-6275
Phone 336-716-0891

2000 West First Street
Protocol Information Office
Suite 101
Winston-Salem, NC 27104
Ways to Give
USNWR 2015-2016Magnet Hospital RecognitionConsumer Choice2014 Best DoctorsJoint Commission Report

Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.