2019 Primary Care Update Conference Registration
January 24 & 25, 2019
Registration starts @ 7:15am each day
Breakfast & Lunch provided

Registration cost:
$75 for one day registration (Thursday or Friday)
$150 for both days

The Millennium Hotel Buffalo
2040 Walden Avenue, Cheektowaga, NY 14225
Questions? Contact Thea Pecht at 716.888.4871 or tpecht@buffalo.edu

Email address *
Directions: Be prepared to print at completion, this will serve as your receipt. Please complete a separate registration form for each individual attending.
First Name *
Your answer
Last Name *
Your answer
Title *
If applicable: What type of physician are you? (Cardiologist, Family Medicine etc.)
Your answer
Street Address *
Your answer
City *
Your answer
State/Province *
Required
Zip Code/Postal Code *
Your answer
Country *
Phone Number (include area code and dashes) // ex: 716-123-4567 *
Your answer
Dietary restrictions *
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