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: firstname.lastname@example.org
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.