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:

Early Bird (Before November 11):

$400 for physicians
$200 for allied health professionals
$50 for residents/medical students/EMTs/Active Military

Standard:

$440 for physicians
$220 for allied health professionals
$55 for residents/medical students/EMTs/Active Military

Post Launch (After January 1):

$480 for physicians
$240 for allied health professionals
$60 for residents/medical students/EMTs/Active Military

If you did not attend a prior UMEM conference (eg, The Crashing Patient 2020-2025, Emergency Cardiology Symposium 2021-2026 or Critical Care Symposium 2021-2026 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 2020-2026, 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.

Name(Required)

First Last Suffix

Email(Required)

Phone

Country Phone Number

Address(Required)

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

Credentials(Required)

Please check all that apply

Military Service

Are you an active member of the military?(Required)

If yes, please tell us what branch:

Organization Information

Hospital/School/Company/Organization Name(Required)

Address(Required)

City State / Province / Region Country

Registration Information

Registration Category(Required)

Total

How did you hear about this conference?(Required)

Please check all that apply.

Internet search

Twitter

Podcast

Referral

I have attended a conference in the past.

Other

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

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.

Early Bird Backend

User Logged in? (hidden)

Password(Required)

Set a password to the online portal.

Enter Password Confirm Password

Billing Information

Total

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

Questions?

Please contact

Program & Events Team

umem.conferences@som.umaryland.edu ♦ Phone: 667-214-2175

University of Maryland School of Medicine ♦ Department of Emergency Medicine

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