Please register for each attendee.

First Name

Last Name

  

Medical Lisc (Required)


Designation



Specialty




 (MD, DO, other)


(OBGYN, FP, Other)

Contact Number

Email Address
(For Cancellation Purposes)


 

For any questions concerning this event, please contact Mary Nava at (210) 301-4395 or email Mary.Nava@bcms.org

Please click the Submit button once.
Click Reset to insert new attendee