2015 Course Schedule

July 27-31 "Hyperbaric Principles & Practice" Zephyrhills, Florida $1,100.00

August 24-28 "Hyperbaric Principles & Practice" Zephyrhills, Florida $1,100.00

July 27-31 "Hyperbaric Principles & Practice" Zephyrhills, Florida $1,100.00

October 26-30 "Hyperbaric Principles & Practice" Zephyrhills, Florida $1,100.00

November 16-20 "Hyperbaric Principles & Practice" Zephyrhills, Florida $1,100.00

Participant Information

E-Mail *(required please)
Full Name:
Name for Badge:
License State: License #:
CHT/CRN Number:
Mailing Address: City: State: Zipcode:
Phone: Home: Office: Fax:
Hyperbaric Center/Hospital/ Wound Care Center at which you work:
City: State: Zipcode: Country:
Hosptial Affiliation:
Hyperbaric Management Company:
Position / Title:
Local Accommodation:

Payment Information
You may print form and fax information or pay online, *recommended (choose course and payment options are at the bottom of the course page) or email us the form with the information; or mail to us through your local postoffice (address at bottom of form).
Please make checks payable to: Caribbean Hyperbaric Medicine, Inc.

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Credit Card Information (Required for CC Transactions)
Card Number: Expiration Date: CVC No:
Name on Card:
Billing Street Address: City: State:
Zipcode: Country:

Third Party Payments:
(if another party is paying your tuition please complete the information below)
Who will pay:
Contact Person:
Phone: Extension:
E-Mail Address:

Please Submit Registration Form and Fees To:
Caribbean Hyperbaric Medicine, Inc.
4920 Airport Road
Zephyrhills, Florida 33542
Phone:(727) 515 · 7379 Fax: (813) 788 · 4200
E-Mail: education@caribbeanhyperbaricmedicine.com



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