Non-Flagler Hospital Providers Registration:
Education and Implementation of the DEA Required MATE Curriculum Into Your Practice Conferences Part 1 &/or Part 2

Non-Flagler Hospital Providers: Checks with appropriate price and date attending may be mailed to:

DEA MATE CME Conference

Flagler Hospital Medical Library

400 Health Park Blvd., St. Augustine, FL 32086.

If less than 7 days prior to conference date, please register and check payment only will be accepted at door. Registration cut off one day prior to conference. Walk-ins without registration will be accommodated on a first come first service basis depending on seat availability.

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* 1. Provider's Name & Designation

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* 2. Provider's license number

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* 3. Provider's email address

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* 4. Best Contact phone number

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* 5. Are you an associated Flagler Hospital provider?

Yes (free to all Flagler Hospital providers)

No (Conference is $249 for June 3 and $249 for June 24. Registration for both dates has discounted rate of $400.

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* 6. I am registering for:

June 3, 2023 (Part 1) - $249

June 24, 2023 (Part 2)-$249

Both dates (Non-Flagler Hospital providers discounted rate for both dates is $400).

Comment

Non-Flagler Hospital Providers Registration:Education and Implementation of the DEA Required MATE Curriculum Into Your Practice Conferences Part 1 &/or Part 2

Question Title

* 1. Provider's Name & Designation

Question Title

* 2. Provider's license number

Question Title

* 3. Provider's email address

Question Title

* 4. Best Contact phone number

Question Title

* 5. Are you an associated Flagler Hospital provider?

Question Title

* 6. I am registering for:

Non-Flagler Hospital Providers Registration:
Education and Implementation of the DEA Required MATE Curriculum Into Your Practice Conferences Part 1 &/or Part 2