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Account Details

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Profile Details

First Name (required)
Last Name (required)
Practice Name (required)
Office Phone (required)
Cell Phone (required)
Medical Specialty
US State (required)
The benefit(s) I am most interested in realizing from CPOMP is(are):
My greatest area(s) if interest include: (required)
How many partners are in the practice? (required)
Of those practice partners, how many have ownership interest in at least one of the real estate properties that the practice occupies? (required)
Our real estate portfolio includes: (required)
The estimated total Fair Market Value of the real estate is $______ (required)
Have you been involved in any sale-leasebacks of your real estate? (required)
Do you anticipate growing your real estate portfolio in the next three years? (required)
If qualified, are you interested in attending the CPOMP Annual Meeting? (required)
How did you hear about CPOMP? (required)
If you selected referral, another conference, or other, please specify