Registration Form: Current Concepts in Coronal Polishing
Please fill out the form entirely. You should receive a confirmation email at the completion of the registration.

Course Information:
Title: Current Concepts in Coronal Polishing
Speaker: Harold Henson, RDH, PhD
Date and Time: Thursday, January 17, 2019 from 5:30-7:30
Location: Midway BBQ (6025 Hwy. Blvd., Katy, TX 77494)
Cost: Free for Study Club Members; $50 for Non-members
CE Credit: 2.0 CE Lecture Hours

If you know of any other dental hygienists that would be interested in the course or study club membership, please forward the information.

If there are any questions or concerns please email us at or call us at 281-392-6000

Email address *
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Best method of contact *
Practice Name *
Your answer
Will you be able to attend this CE Course? *
Never submit passwords through Google Forms.
This form was created inside of Report Abuse - Terms of Service