If you have any questions, please email us at information@tipsnec.org Name* First Last Email* Medical License Number* Specialty*Addiction MedicineAllergy/ImmunologyAnesthesiologyCardiac ElectrophysCardiac SurgeryCardiologyChild PsychiatryClinical PathologistColo-rectal SurgeryDentistryDermatologyDiagnostic RadiologyEmergency MedicineEndocrinologyENTFamily MedicineFamily PracticeGastroenterologyGeneral PracticeGeneral SurgeryGeriatric MedicineGeriatricsGynecologyHand SurgeryHead Neck SurgeryHematologyHematology-OncologyInfectious DiseaseInterventional CardiologyInternal MedicineNeonatal MedicineNeonatologyNephrologyNeurologyNeurosurgeryNuclear MedicineOB/GYNOncologistOncologyOphthalmologyOrthopedicsOther SpecialistsPain ManagementPathologyPediatric Emergency MedicinePediatricsPharmacologyPhysMedicine RehabPlastic SurgeryPreventive MedPsychiatryPulmonary Critical CarePulmonary MedicineRadiation OncologyRadiologyRheumatologySleep MedicineSurgeryThor/Vasc/GenUrologyVascular SurgeryRetired PhysicianOtherSpecify Specialty if selected 'Other' above* Cell Phone Wellness and Lifestyle Medicine Symposium Registration Price: Payment Method Pay by PayPal/Credit Card Pay by Check Please mail your Check Payment to: 1706 N. Britain Rd. Irving, TX 75061 Your registration will be processed once your payment is received. If you have any questions, please email us at information@tipsnec.orgYou will be redirected to PayPal to complete your payment after you click 'Submit'. If you don't have a PayPal account, you can pay using Credit Card on the PayPal Payment screen as well. Please complete the PayPal Payment and your registration will be marked paid once your payment is processed.NameThis field is for validation purposes and should be left unchanged.
