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Registration Form

Ethical and Legal Issues in Pediatrics

October 23 - 24, 2014

** Those paying with a credit card must print the form, sign it, and fax, scan, or mail their information. Credit Card payments can not be submitted through the online form. 

Payment can be mailed or faxed to the following address:
Fax: 843 876-4866
Scan to: fier@musc.edu

Institute of Human Values in Health Care
Attn: Megan Fier

25 Courtenay Drive
Suite 7028  MSC 295
Charleston, SC  29425-2950


For Students, Faculty, Staff or those paying with a Purchase order, please fill out this registration form and submit to register for the Lectureship.

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The registration fee includes continental breakfast, coffee breaks, lunch, course materials, and continuing education credit processing.
Registration for faculty, students or staff:
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Thomas Antley Pitts, II, M.D. (1893-1991)