PVICME: Registration

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Contact PVICME

Pacific Vascular Institute for Continuing Medical Education (PVICME)
11714 North Creek Pkwy N
Suite 100
Bothell, WA. 98011
Phone: (425) 398-7772
Fax: (425) 486-8976

or email PVICME Director at

2012 Registration Form

(Registrants are required to complete all fields below marked with *)

*First Name:

*Last Name:

*Credentials:

*Email Address:

Billing Information

*Bill to (name):

  Department:

*Address:

*City:

*State:

*Zip Code:

*Phone:

  Fax:

Please select a course(s) below that matches your requirements.

TRANSCRANIAL DOPPLER & IMAGING COURSE

March 21 - 23, 2012

Physicians [Course Fee: $875.00]

Fellows/Residents [Course Fee: $800.00]

Technologists/Allied Health Professional [Course Fee: $775.00]

Note: Course Location - Swedish/Cherry Hill Hospital Campus, Seattle, WA

ABDOMINAL VASCULAR COURSE

April 20 - 21, 2012
[Course Fee: $675.00]

PHYSICIAN INTERPRETATION COURSE

April 27 - 28, 2012

Physicians [Course Fee: $800.00]

Fellows/Residents [Course Fee: $750.00]

Technologists/Allied Health Professional [Course Fee: $700.00]

VASCULAR ULTRASOUND COURSE

“A foundation to build from”

MAY

Complete 4-Day Series

May 21 - 24, 2012
[Course Fee: $1,025.00]

Carotid Duplex / Upper Extremity (Arterial & Venous), Days 1 & 2

May 21 - 22, 2012
[Course Fee: $650.00]

Renal Vascular / Lower Extremity Arterials, Day 3

May 23, 2012
[Course Fee: $300.00]

Lower Extremity Venous, Day 4

May 24, 2012
[Course Fee: $300.00]

VENOUS INSUFFICIENCY COURSE

May 25, 2012
[Course Fee: $450.00]

Please call (425) 398-7772 to make payment arrangements and/or if you have any questions with regard to the courses, thank you.

Deposit: A $250.00 deposit is required to secure enrollment. Please include credit card information or check with registration. Course Cancellation: Cancellation thirty (30) days prior to the course. Full refund less a $125 administrative fee. Cancellation (21))twenty one days or less prior to the course. Forfeiture of the $250.00 deposit. A minimum of 8 students is required to confirm a course. Please do not book nonrefundable airline tickets unless you have confirmed the minimum has been met. PVICME/ Pacific Vascular will not assume any liability for nonrefundable airline tickets. PVICME, a division within Pacific Vascular, reserves the right to cancel any course within 10 days of the course for any reason. PVICME 18702 North Creek Parkway, Suite 212, Bothell, WA 98011 Phone (425) 398-7772 / Fax (425) 486-8976 / Web site www.pvicme.com. Email dfields@pacificvascular.com.