AHA Physician Leadership Circle Dinner Registration - 2020 Dinners

Please register for the April 6th, May 6th, and/or July 8th Physician Leadership Circle private dinners below and to receive more information about upcoming in-person events. These events are reserved for AHA member physicians and physicians affiliated with AHA member hospitals and health systems.

Question Title

* 1. Contact Information

First Name

Last Name

Credentials

Organization

Title/Role

Email

City

State

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* 2. Alternate Contact or Executive Assistant Information

First Name

Last Name

Email

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* 3. Are you an AHA member or a physician affiliated with an AHA member hospital or health system?

Yes

No

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* 4. I would like to register for:

April 6th dinner in Austin at 6 pm at the Archer Hotel Austin

May 6th dinner in Minneapolis at 6 pm at the W Minneapolis - The Foshay

July 8th dinner in Louisville at 6 pm at the Hotel Distil

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* 5. I would like to receive more information about the upcoming Physician Leadership Circle Executive Forum dinners in 2021:

Yes

No