PCI21 - Registration Form: September 2021 (In Person) - Promedica International CME

PCI21 SEPT - Flyer (2)

Registration Form for In Person Workshop

Precision PCI will be a deep-dive live and in person course on coronary imaging, physiology, and techniques of complex PCI. The agenda includes lectures from US and international experts, case examples, a live case transmission, and hands-on opportunities.

Sponsored by a grant from Philips
Name*
First Last
Degrees/Credentials
Enter the degrees/credentials you would like to appear on your name badge.
Salutation*
Email Address*
Registration and symposium communication will be sent to this email address.
Enter Email Confirm Email
Hospital/Affiliation*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number*
Phone Type*
Philips Representative Name
Please enter the name of your Philips representative. If you do not currently have a Philips representative, please note that you may be contacted by a representative in your area.
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Program, Hotel, and Travel

The Precision PCI program will cover the following expenses for accepted registrations:

1) Registration Fee - you will receive a registration confirmation via email for your records

2) Coach-Class Airfare - the registration confirmation will include instructions on how to make your flight arrangements with the course travel agent.

3) Lodging: One Night Room and Tax - The course has rooms available at the Beverly Hills Hotel and the Hotel Bel-Air and will cover one night room and tax. If you are interested in staying additional nights at your own expense, we will be happy to help you arrange that at the group rate of $475 plus tax per night. Please see the information below.

4) Ground Transportation - please arrange your own transportation to and from the airport via Uber, Lyft, or an equivalent. You will submit these receipts for reimbursement after the program concludes.

The program will tentatively begin at 2:00 PM Pacific Daylight Time (PDT) on Friday, September 10, 2021, and conclude at approximately 4:00 PM PDT on Saturday, September 11, 2021. The final agenda and timing will be provided to you as soon as possible.
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Hotel Preference*
Please indicate your hotel preference below. We cannot guarantee your preference at this time, however will advise you of your confirmed room details approximately six weeks to one month before the program begins.
- The Beverly Hills Hotel, 9641 Sunset Blvd, Beverly Hills, CA 90210
- Hotel Bel-Air, 701 Stone Canyon Rd, Los Angeles, CA 90077
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Would you like to reserve an additional night at the hotel?*
The group rate for meeting attendees is $475 plus tax, per night. Important: If you choose "yes", we will contact you to collect credit card information to secure the additional night. The hotel will require full payment at the time of reservation and the deposit is non-refundable.
- Yes
- No
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Hotel Arrival Date*
Reminder: The dates of the program are September 10 - 11, 2021.
MM slash DD slash YYYY
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Hotel Departure Date*
Reminder: The dates of the program are September 10 - 11, 2021.
MM slash DD slash YYYY
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