ASIPP Comprehensive Review Course in
Controlled Substance Management
February 24 -25-2012
February 26, 2012
Pointe Hilton Squaw Peak Resort
7677 North 16th Street
Phoenix, Arizona, 85020
PHYSICIAN INFORMATION: Please answer all of the following questions:
Physician Registration Fee for Controlled Substance Management Comprehensive Review and Competency Exam
If registering as a Fellow or Resident, please list the name of your fellowship program, university, or hospital, the coordinator, and contact number.
Non-Physician Registration for Controlled Subtance Management Comprehensive Review and Associate Certification Exam
ASIPP reserves the right to cancel this course upon reasonable notice and will assume no financial obligation to registrants for cancellation for reasons beyond its control. Registration fees will be refunded however, costs incurred by the registrants, such as airline or hotel fees or penalties, are the responsibility of the registrants. ASIPP requires a 30-day notice of cancellation. Cancellations must be submitted in writing by January 25, 2012. An administrative fee of $200 will be assessed. Cancellations after January 25, 2012 but prior to February 9, 2012, will forfeit 50% of their registration fee. No cancellations accepted after February 9, 2012. Refunds will be sent after the conclusion of the meeting.