Skip to main content
Information Technology Security Incident
Click here
for an updated notice about a data privacy incident at Capital Health.
Main navigation
Medical Services
For Patients & Visitors
Locations
Medical Group
Search
Find a Doctor
Keyword
Utility Menu
Contact
Foundation
Careers
Patient Portals
Main navigation
Medical Services
For Patients & Visitors
Locations
Medical Group
Search
Find a Doctor
Keyword
Attendee Registration - Capital Health Physician and Advanced Practice Provider
In This Section
You must have JavaScript enabled to use this form.
2025 Capital Health’s Annual Continuing Education Conference:
Inspiring Minds, Advancing Medicine Together
March 14-15, 2025
Borgata Hotel & Casino
1 Borgata Way
Atlantic City, NJ 08401
RATES:
Early Bird
(10/1/24 - 11/15/24)
Standard
(11/16/24 - 2/24/25)
Late*
(2/25/25 - 3/7/25)
Physicians and Advanced Practice Provider
$450
$500
$600
*Hotel rates no longer guaranteed after 2/24/25
Please complete the form below to register for Capital Health’s Annual Continuing Education Conference
*
indicates required field
Name
First Name
Last Name
Address
Address
Address 2
City/Town
State/Province
- Select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federate States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Phone Number
Email Address
Name of Organization/Affiliation
- Select -
Capital Health System
Provider License Type
- Select -
MD
DO
APP
Medical Specialty
Will you attend the FRIDAY evening reception?
Yes, I will attend
No, I am unable to attend
Will you be bringing a guest?
Yes, I will bring a guest
No, I will not bring a guest
Please provide your guest’s name
Will you attend the SATURDAY evening GALA?
Yes, I will attend
No, I am unable to attend
Will you be bringing a guest?
Yes, I will bring a guest
No, I will not bring a guest
Please provide your guest’s name
I have dietary restrictions
Yes
No
Please specify your restrictions here
By checking this box, I am verifying that I have continuing medical education dollars to support my registration
Leave this field blank