*Name of Doctor (with credentials):
Name of 2nd Doctor (optional):
Name of 3rd Doctor (optional):
Company:
*Address:
*City:
*State:
*Zip Code:
*Email:
*Phone:
Fax:
*Select Seminar City and Date:
*†Preferred Method of Payment
Questions/Comments:
 
Payment Info †

Paypal or Credit Card
Everyone will be directed to the Payment Page of the site after the registration form is submitted. You can choose to pay or just go back to the home page. If paying for more than one doctor, please select the appropriate number of doctors at checkout.

Send A Check
A registration confirmation email will be sent with further instructions or just send the checks to:

Zurbee Continuing Education
P.O. Box 2875
Olathe, KS 66063

Pay at the Door
You can choose to pay for the seminar at the door. However, the fee for this will be $275.

Have Questions

Ph: (888) 611-3041
Give us a call and we will answer any question or concerns that you might have

Web Mail Us
Simply fill out the form and press send, it is easy as that.
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