REGISTRATION FORM

If you have attended a previous UMEM Conference, you will need to make sure you are logged in with your website account before registering for this course. If you have forgotten your password, you can reset it using the link under the login form.

A reminder that your username is the email address you used to register for previous UMEM events.

CME: CME information.

Registration Pricing & Information:

$225 for physicians for each day
$125 for allied health professionals for each day
$50 for residents/medical students/EMTs/Active Military for each day

Discounts:

Register for both days, get $50 off! Early bird discount of 10% off is available until September 18. Discounts available for residency programs.

Email umem.conferences@som.umaryland.edu

If you did not attend a prior UMEM conference (eg, The Crashing Patient 2020-2023, Emergency Cardiology Symposium 2021-2024 or Critical Care Symposium 2021-2024) please skip this login section. You will be asked to set a username and password in the below form.

If you have attended any previous conferences between 2020-2024, you should have a log in. Therefore, please complete the below log in information. If you have questions, contact us at umem.conferences@som.umaryland.edu.

"*" indicates required fields

Name*

First Last

Email*

Enter Email (This will be your USERNAME used for log-in) Confirm Email

Phone Number

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credentials*

Please check all that apply.

Military Service

Are you an active member of the military?*

Active Military: You can register for the $50/day rate. Please select Medical Students/Residents/Fellows/EMTs/Active Military when asked your Registration Category below.

If yes, please tell us what branch:

Organization Information

Hospital/School/Company/Organization Name*

Hospital/School/Company/Organization Location*

City State / Province / Region Country

Registration Information

Registration Category*

Required to determine Wednesday + Thursday registration pricing. Early Bird registration discount (10%) will be subtracted from your registration if you register prior to September 18.

Wed (Dec 4) Conference Registration (PHY)

$225 Physician Registration - Wednesday (Dec 4) Conference

Thursday (Dec 5) Conference Registration (PHY)

$225 Physician Registration - Thursday (Dec 5) Conference

Wednesday (Dec 4) Conference Registration (AHP)

$125 PA, NP, RN, CRNA Registration - Wednesday (Dec 4) Conference

Thursday (Dec 5) Conference Registration (AHP)

$125 PA, NP, RN, CRNA Registration - Thursday (Dec 5) Conference

Wednesday (Dec 4) Conference Registration (MS/RES/FELL/EMT/Active Mil)

$50 Medical Student/Resident/Fellow/EMTs/Active Military Registration - Wednesday (Dec 4) Conference

Thursday (Dec 5) Conference Registration (MS/RES/FELL/EMT/Active Mil)

$50 Medical Student/Resident/Fellow/EMTs/Active Military Registration - Thursday (Dec 5) Conference

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PHY Bundle

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APP Bundle

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MS/RES Bundle

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Wednesday Conference Backend

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Thursday Conference Backend

How did you hear about this conference?*

Please check all that apply.

Internet search

Twitter

Podcast

Referral

I have attended Conference in the past

Other

Would you like to receive emails about other University of Maryland Department of Emergency Medicine education events?*

Payment Information

International Participants: We have noticed that some people are having trouble with PayPal accepting payment. To enable international transactions on your Debit or Credit Card, Login to Netbanking > Cards > Credit/Debit Cards > Request > International Enable. For Debit cards –Login to Netbanking > Cards > Credit/Debit Cards > Request > International Enable. Paypal accepts payments from 200 countries (https://www.paypal.com/us/webapps/mpp/country-worldwide) if your country is not on the list please email dlucadamo@som.umaryland.edu to get additional help.

Sub-Total

Price: $0.00

Coupon

Enter the code EBTCP2024 to receive 10% off prior to September 18.

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Early Bird Backend

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User Logged in? (hidden)

Password*

Set a password to access the online portal

Enter Password Confirm Password

Billing Information

Total

Early Bird registration discount (15%) has been subtracted from your registration if you register prior to September 18.

Billing Address

This is the address listed on record for your credit card.

Same as Address Listed Above

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Payment Method

Comments

This field is for validation purposes and should be left unchanged.

Questions?

Please contact

Doreen Lucadamo, CMP, DES, HMCC

Sr. Program Coordinator, Courses/Conferences

dlucadamo@som.umaryland.edu ♦ Phone: 443-562-8630

University of Maryland School of Medicine ♦ Department of Emergency Medicine

110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, MD 21201