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Larell Denture Training 5 Registration

Thank you for your interest in the Larell One Step Denture Training.

The training will take place on Friday, March 14th from 5pm -9pm and will continue on Saturday, March 15th from 8am-4pm. The Friday night dinner and didactic will take place at the DoubleTree by Hilton Williamsburg Hotel & Conference Center. The Saturday event will take place at Lackey Free Clinic, Yorktown, VA. Participants must attend both Friday and Saturday sessions.

Please enter the information below to register.

Thank you,
Tracey van Marcke

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* Registrant Information

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Last Name:

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Cell Phone:

Email Address:

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* Continuing Education credit will be offered by the Virginia Dental Association (VDA) for this training session. Since attendees will be providing patient care, the VDA is requiring VHCF to verify licensure of all registrants via the Virginia Department of Health Professionals license database.

All dentists are also required to provide to VHCF (in advance) a copy of current liability insurance coverage in order to participate in the training session. Please send proof of coverage to Tracey van Marcke, Dental Opportunities Champion, via fax at (804) 828-4370 or email to tracey@vhcf.org at the time of registration.

Thank you.

I understand the above requirements for participation and will provide necessary information to VHCF in a timely manner.

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* Registrant Information

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* Please describe any dietary restrictions or enter 'None'.