2027 The MyoSphere presents

2027 Insider Rate Registration Form

First name

Last name

Enter the name you would like on your Name Tag (i.e., nickname)

Multi-line address

Country/Region

Address

City

Zip / Postal code

Company name

Phone

What is your profession/credentials?

Enter your full professional title, including all credentials, as you would like it to appear on your name tag.

How will you join? (You can change this later)

In-person

Virtually

Watch Recording (Must complete by DATE COMING SOON for ASHA CEUs)

ASHA and AGD CEUs will be AVAILABLE for online. ASHA CEUs will be available for recording too!

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CEU Reporting

Would you like CEUs reported?

If you selected ASHA/AGD, please enter your ID number.

Please enter your name as it appears in your ASHA or AGD records. This is typically your professional name, not a nickname.

NOTE: Everyone will receive a Certificate of Completion for the Symposium.

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Attendee Tags

Comments or Questions:

If you have any questions, special requests, or details you'd like us to know, feel free to leave them here:

Need to reach us directly?

Email: info@themyosphere.com

REQUIRED Please confirm that you understand the policies listed at the bottom of this registration page under Disclosures, Cancellations, Substitutions.

Questions? Email info@themyosphere.com

The MyoSphere Registration

$750

2027 The MyoSphere presents

2027 Insider Rate Registration Form

Email: info@themyosphere.com