Registration: EPIC Pediatric Obesity Let's Talk with Dr. Dina Rose

Webinar, phone link, CME/CEU information, and handouts will be emailed to registrants prior to the event.
Questions starred below (*) require answers.

Name, email, phone

Question Title

* 1. Name, email, phone

Your Professional credentials:

Question Title

* 2. Your Professional credentials:

Practice, hospital, or organization name:

Question Title

* 3. Practice, hospital, or organization name:

Specify pediatric, family medicine, or other practice or organization type

Question Title

* 4. Specify pediatric, family medicine, or other practice or organization type

Expected number of participants from my site. (If only you, then "1")

Question Title

* 5. Expected number of participants from my site. (If only you, then "1")

Specific questions you would like to see addressed by the speaker on this webinar/teleconference.
Your handouts and connecting instructions will be emailed to you.
We look forward to your participation!

Question Title

* 6. Specific questions you would like to see addressed by the speaker on this webinar/teleconference.
Your handouts and connecting instructions will be emailed to you.
We look forward to your participation!

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