CPOMP 2025 Registration

Contact Details

Name(Required)

First Last

Title(Required)

Email(Required)

Practice(Required)

Office Phone

Cell Phone(Required)

Address

Street Address City State ZIP Code

Practice Info

The number of providers in our practice:

Of those providers, approx. ___% have ownership in some part of the real estate.

The size of our real estate portfolio after completion of new projects or sales is:

We have been involved in a sale-leaseback of our real estate.

Yes

No

We have outside JV partners in our real estate.

Yes

No

We plan to expand our real estate portfolio in the future.

Yes

No

Conference Info

Breakout Session Choice(Required)

Breakout sessions will occur on Friday morning (9/12). If you have two attendees representing your practice, we ask that one attends Track 1 and the other Track 2. If you both choose the same track, we will ask one of you to change.

Number of guests (significant other and/or children):(Required)

We like to welcome your guests. Please indicate who will be joining you.

Name(s) of your guest(s):

This will help us prepare name tags for your guests.

Is there another contact (i.e. assistant) we should communicate with regarding your registration?

Preferred method of vendor contact:(Required)

Email

Mail

Are there any other medical groups that would benefit from attending CPOMP 2025?

Our members are the best source of knowing which independent groups might benefit from attending a CPOMP meeting. Please provide their contact information.

Do you have any disabilities or special dietary needs in order to fully participate in this meeting?

How did you hear about CPOMP?

Email

Mailer

Referral

Social Media

Web search

Attendance at another conference

Other

If you selected referral, another conference, or other, please specify:

CPOMP 2025 Registration(Required)

Price:

Coupon

Total

Credit Card

Email Address for Receipt

CPOMP 2025 Annual Meeting Registration