Link To Registration Form: /docs/Registration%20Form.docx
Link To Online Registration Form: https://forms.gle/JZz7v9cPw2om8KQG7
Registration Form For: CardioSarasota, Florida 22/22/22
22 nd Annual National Sarasota, Florida Congress for
Cardiovascular Disease Prevention and Optimal Treatment Update
Hosted by 22 of the Most Renowned National and International Professors in February 2022
Physicians……………………………………………..$250 Prior to Sept. 15, 2021, Thereafter $400
Other Healthcare Professionals…………………………………………………………...………..$150
ISCVDP Members and Previous Attendees limited to 100 Prior to Sept. 15, 2021…………..$100
Medical Students and Nurses (first 50 registrants), prior to Sept. 15, 2021.…………………..Free
Public invited free for Saturday Afternoon session. Space is limited, must pre-register
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Optional Breakfast for Health Care Providers Friday February 4, 2022 |
YES, I will attend |
NO, I will not attend |
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Optional lunch for Health Care Providers: Friday February 4, 2022, Lunch for the first 100 Registrants |
YES, I will attend |
NO, I will not attend |
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Optional Dinner Program by invitation: Physicians Only Friday February 4, 2022, Space Limited |
YES, I will attend |
NO, I will not attend |
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Optional Breakfast for Health Care Providers Saturday February 5, 2022 |
YES, I will attend |
NO, I will not attend |
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Optional lunch for Health Care Providers: Saturday February 5, 2022, Free Lunch for the first 100 Registrants |
YES, I will attend |
NO, I will not attend |
Make checks payable to: International Society for Cardiovascular Disease Prevention
Prevention and mail to the address below. *
FOR CREDIT CARD PAYMENT CALL (941) 366-9805
Name: ___________________________________________________
Title: _____________________________________________________
Address: __________________________________________________
City: _____________________________State: _____Zip: __________
Facility: ___________________________________________________
Phone: ___________________________________________________
E-mail: ___________________________________________________
Name on Card______________________________________________
Card No. ____________________________________Exp____/_______
Send Registration Form & Appropriate Fee to:
International Society for Cardiovascular Disease Prevention
P.O. Box 433, Sarasota, FL 34230
Attn: M. El Shahawy, MD, Program Director