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Register for Wasted Days

Please fill out our meeting registration form!

Salutation
First Name
Last Name
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Title
Organization
Address 1
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State/Province/Territory Licensed in:
Doctor and team member names attending Wasted Days and Sleepless Nights Advanced course
Total # of persons attending the retreat:
In case of an emergency at the meeting, please contact this person:
Phone:
What previous intro to dental sleep medicine courses have you attended?
How many sleep appliances have you done in the last 12 months? Requirements for this coure is at least 10 in the last 2 years.
Do you own/use any home sleep test units? Yes No
Are you currently using a dedicated EMR or software for your sleep practice? Yes No
Are you currently using a third party billing company or billing yourself through medical insurance for your patient treatment?
Are there any special accommodations you need to make your conference experience more comfortable? (i.e., hearing assistance, accessibility, diet considerations)
Where did you learn about this course?
Elite Code, if any
Total Registration Cost
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The organization reserves the right to substitute lecturers or to cancel or reschedule sessions due to low enrollment or other unforeseen circumstances.

About Us

FAQ

Our Newest Event:

Wasted Days and Sleepless Nights

Newly Registered Speakers:

Rubin Cheek

Fred Weiner

J.A. Shapira

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"The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn."
��-- Alvin Toffler

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Phones and Pagers at Meetings