Schedule an Experts in Arthritis Session

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Please fill in as much information as you can. If you do not have a healthcare professional to present the program USBJI will be happy to locate a presenter for you.

Venue

Preferred date(s) and time(s)

Expected Number of Participants

Session Venue Name

Type of Session *

Live Session

Webinar Session

Videoconference Session

Recorded Session

Street Address

Street Address Line 2

City

Postal Code

State/Province

Organizer

Name Prefix

First Name *

Middle

Last Name *

Name Suffix

Position

Organization Name

Address type

Street Address

Street Address Line 2

City

State/Province

Postal Code

Country

Phone Number *

Phone Extension

Phone Location

Email *

Do you have a healthcare professional to lead the presentation? *

Presenter

Note: If you have more than one presenter, please provide their information in the "Notes" field at the end.

Name Prefix

First Name

Middle

Last Name

Name Suffix

Credentials

May include academic credentials (e.g. MD, PhD), certifications (e.g. PMP, CFP), affiliations (AAO SJ), and the like.

Job Title

Organization Name

Presenter Address

Street Address

Street Address Line 2

City

State/Province

Postal Code

Phone Number

Phone Extension

Session

Session Location Name *

Address

Country

Address 1

Address 2

City

State

ZIP code

Name

Phone

Best number to reach you at.

Position

Professional Organization

List the professional organizations you are a member of.

USBJI will provide a HealthCare Professional to present if you do not have one.

Name

USBJI will provide a HealthCare Professional to present if you do not have one.

Credentials

Phone

Best number to reach you at.

Position

Promoting the session(s)

Bookmarks Quantity:

With date, time, place, and speaker details.

Notes

Collaborate · Innovate · Educate

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Schedule an Experts in Arthritis Session

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Thank You