Online Conference Registration

Ultrasound for Pain MedicineWorkshopOfficial Satellite 
Symposium 13th World 
Congress on Pain (USPM10)

Welcome to the online registration page for the Ultrasound for Pain Medicine Workshop Official Satellite Symposium 13th World 
Congress on Pain (USPM10). Please follow these steps to complete your registration.

Please Note: your registration will not be considered complete until you provide your payment information.

Need help completing this form? Please contact
Christine Drane at 416-603-5118 or christine.drane@uhn.on.ca

Your name:
	Title (Occupation)*
	First*
	Last*
		License Number*
Your Contact Information:
	Organization/Co. Name*
	Mailing Address*
	Email Address*
	Telephone*		Ext		Fax
Please indicate your preference below. Cancellation Policy: Full refund less $100.00 administration costs. Please Note: your registration will not be considered complete until you provide your payment information.
	Registration Fees (limited to 84 participants) All fees are in Canadian Funds
	Meeting Fee for Aug. 27-28 meeting			$850	view program
	Meeting Fee for Aug. 27 (optional) session			$50	view program
	Dinner event - Aug 27 - Boat Cruise			$150
			If "yes" to attending the Boat Cruise, will you need transportation?
Workshop Information - Contact Christine Drane at: 416-603-5118 or christine.drane@uhn.on.ca
Please ensure that you have completed all fields before clicking the submit button