{"id":12093,"date":"2025-01-31T22:06:58","date_gmt":"2025-02-01T03:06:58","guid":{"rendered":"https:\/\/cms.umem.org\/?page_id=12093"},"modified":"2026-03-20T10:04:32","modified_gmt":"2026-03-20T14:04:32","slug":"ecs26-registration","status":"publish","type":"page","link":"https:\/\/cms.umem.org\/index.php\/emergency-cardiology-symposium-2026\/ecs26-registration\/","title":{"rendered":"ECS26-Registration"},"content":{"rendered":"<div id=\"cs-content\" class=\"cs-content\"><div id=\"x-section-1\" class=\"x-section cs-ta-center\" style=\"margin: 0px;padding: 5px 0px; background-color: #ffffff;\" ><div class=\"x-section-separator x-section-separator-top x-section-separator-angle-out\" style=\"top: 0px; height: 50px;\"><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" version=\"1.1\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" class=\"angle-top-out\" style=\"fill: #ffffff;\"><polygon points=\"50,0 100,100 0,100\"\/><\/svg><\/div><div id=\"\" class=\"x-container max width\" style=\"margin: 0px auto;padding: 0px;\" ><div  class=\"x-column x-sm x-1-1\" style=\"padding: 0px;\" ><img decoding=\"async\"  class=\"x-img x-img-none\"  src=\"https:\/\/cms.umem.org\/wp-content\/uploads\/2026\/03\/Untitled.png\" ><h1  class=\"h-custom-headline h2\" style=\"color: hsl(0, 86%, 25%);\"><span>Registration & CME Information<\/span><\/h1><\/div><\/div><\/div><div class=\"x-section e12093-e6 m9bx-0 m9bx-1\"><div class=\"x-row x-container max width e12093-e7 m9bx-3 m9bx-4 m9bx-6\"><div class=\"x-row-inner\"><div class=\"x-col e12093-e8 m9bx-8\"><h2  class=\"h-custom-headline cs-ta-center h2 accent\" style=\"color: #770909;\"><span>IMPORTANT<\/span><\/h2><div id=\"\" class=\"x-text\" style=\"\" ><p><strong><span style=\"color: #000000;\">Have you been to Crashing Patient, Emergency Cardiology Symposium, or Critical Care Symposium since 2020?<\/span><\/strong><\/p>\n<\/p>\n<p><span style=\"color: #000000;\">If so please <strong>LOGIN<\/strong> before completing the registration form or you will get an error.<\/span><\/p>\n<p><span style=\"color: #000000;\">If you see \"LOGIN\" on the menubar you are not logged in. \"Account\" will show once logged in.<\/span><\/p>\n<\/div><a  class=\"x-btn x-btn-pill x-btn-large\"  href=\"https:\/\/cms.umem.org\/index.php\/login\/\"     data-options=\"thumbnail: ''\"><i  class=\"x-icon mvn mln mrs x-icon-o-computer-classic\" data-x-icon-o=\"&#xf8b1;\" aria-hidden=\"true\"><\/i>Login<\/a><\/div><\/div><\/div><\/div><div id=\"x-section-2\" class=\"x-section\" style=\"margin: 0px;padding: 5px 0px 10px; background-color: #ffffff;\" ><div id=\"\" class=\"x-container max width\" style=\"margin: 0px auto;padding: 0px;\" ><div  class=\"x-column x-sm x-1-1\" style=\"padding: 0px;\" ><div id=\"\" class=\"x-text\" style=\"\" ><p style=\"text-align: left;\"><span style=\"color: #000000;\"><strong>All lectures are offered 100% virtually. Lectures are pre-recorded and available on-demand for asynchronous viewing.<\/strong><\/span><\/p>\n<ul style=\"text-align: left;\">\n<li><span style=\"color: #000000;\">Registration is FREE to participate in the Emergency Cardiology Symposium. No credits or certificate is offered for free registrations.<\/span><\/li>\n<li><strong><span style=\"color: #000000;\">Physicians interested in earning CME <\/span><\/strong><span style=\"color: #000000;\">(<em>see below for more information about CME<\/em>).<\/span>\n<ul style=\"text-align: left;\">\n<li><span style=\"color: #000000;\">Registration to qualify for CME is $150.<\/span><\/li>\n<li><span style=\"color: #000000;\">Lectures will be available April 1, 2026<\/span><\/li>\n<li><span style=\"color: #000000;\">At the conclusion of the Symposium, learners will need to submit a survey to log participation.<\/span><\/li>\n<\/ul>\n<\/li>\n<li><strong><span style=\"color: #000000;\">Learners interested in obtaining a Certificate of Participation (COP) <\/span><\/strong><span style=\"color: #000000;\">(<i>does not include CME)<\/i><\/span>\n<ul style=\"text-align: left;\">\n<li><span style=\"color: #000000;\">Registration for a COP $15.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p style=\"text-align: left; margin-bottom: 0;\"><span style=\"text-decoration: underline;\"><span style=\"color: #800000;\"><strong>PAYMENT INFORMATION<\/strong><\/span><\/span><\/p>\n<ul style=\"text-align: left; margin-top: 0; margin-bottom: 0;\">\n<li><span style=\"color: #000000;\">Credit Card payment online is completed using PayPal.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: left; margin-top: 0; margin-bottom: 0;\"><span style=\"text-decoration: underline;\"><span style=\"color: #800000;\"><strong>CANCELLATION &amp; REFUND POLICY<\/strong><\/span><\/span><\/p>\n<ul style=\"margin-top: 0;\">\n<li style=\"text-align: left;\"><span style=\"color: #000000;\">Symposium registration is refundable only if submitted in writing to Doreen Lucadamo <a href=\"mailto:dlucadamo@som.umaryland.edu\" style=\"color: #000000;\">dlucadamo@som.umaryland.edu<\/a> and only if you have not started lectures.\u00a0<\/span><\/li>\n<li style=\"text-align: left;\"><span style=\"color: #000000;\">Refunds will be made within 5 days of request if payment was made by credit card. 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type='text' name='input_1.6' id='input_107_1_6' value='' tabindex='4'  aria-required='true'     \/>\n                                                    <label for='input_107_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            <span id='input_107_1_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.8' id='input_107_1_8' value='' tabindex='5'  aria-required='false'     \/>\n                                                    <label for='input_107_1_8' class='gform-field-label gform-field-label--type-sub '>Degree<\/label>\n                                                <\/span>\n                        <\/div><\/fieldset><fieldset id=\"field_107_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below 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gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_2_2' id='input_107_2_2' value='' tabindex='7'   aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_107_2_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><fieldset id=\"field_107_12\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' 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tabindex='12'     aria-required='true'    \/>\n                                        <label for='input_107_12_4' id='input_107_12_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_107_12_5_container' >\n                                    <input type='text' name='input_12.5' id='input_107_12_5' value='' tabindex='13'   aria-required='true'    \/>\n                                    <label for='input_107_12_5' id='input_107_12_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_107_12_6_container' >\n                                        <select name='input_12.6' id='input_107_12_6' tabindex='14'  aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' selected='selected'>United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_107_12_6' id='input_107_12_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_107_31\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Credentials<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_107_31'>Please check all that apply.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_107_31'><div class='gchoice gchoice_107_31_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.1' type='checkbox'  value='MD'  id='choice_107_31_1' tabindex='15'  aria-describedby=\"gfield_description_107_31\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_1' id='label_107_31_1' class='gform-field-label gform-field-label--type-inline'>MD<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.2' type='checkbox'  value='DO'  id='choice_107_31_2' tabindex='16'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_2' id='label_107_31_2' class='gform-field-label gform-field-label--type-inline'>DO<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.3' type='checkbox'  value='NP'  id='choice_107_31_3' tabindex='17'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_3' id='label_107_31_3' class='gform-field-label gform-field-label--type-inline'>NP<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.4' type='checkbox'  value='PA'  id='choice_107_31_4' tabindex='18'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_4' id='label_107_31_4' class='gform-field-label gform-field-label--type-inline'>PA<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.5' type='checkbox'  value='RN'  id='choice_107_31_5' tabindex='19'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_5' id='label_107_31_5' class='gform-field-label gform-field-label--type-inline'>RN<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.6' type='checkbox'  value='LPN'  id='choice_107_31_6' tabindex='20'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_6' id='label_107_31_6' class='gform-field-label gform-field-label--type-inline'>LPN<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.7' type='checkbox'  value='EMT'  id='choice_107_31_7' tabindex='21'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_7' id='label_107_31_7' class='gform-field-label gform-field-label--type-inline'>EMT<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.8' type='checkbox'  value='Medical Student'  id='choice_107_31_8' tabindex='22'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_8' id='label_107_31_8' class='gform-field-label gform-field-label--type-inline'>Medical Student<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.9' type='checkbox'  value='Resident'  id='choice_107_31_9' tabindex='23'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_9' id='label_107_31_9' class='gform-field-label gform-field-label--type-inline'>Resident<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.11' type='checkbox'  value='Fellow'  id='choice_107_31_11' tabindex='24'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_11' id='label_107_31_11' class='gform-field-label gform-field-label--type-inline'>Fellow<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_31_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.12' type='checkbox'  value='Other'  id='choice_107_31_12' tabindex='25'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_31_12' id='label_107_31_12' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_107_39\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Hospital Information<\/h3><\/div><div id=\"field_107_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_107_13'>Hospital\/School\/Company\/Organization Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_107_13' type='text' value='' class='medium'   tabindex='26'  aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_107_14\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Hospital\/School\/Company\/Organization Location<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_city has_state has_country ginput_container_address gform-grid-row' id='input_107_14' >\n                        <span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_107_14_3_container' >\n                                    <input type='text' name='input_14.3' id='input_107_14_3' value='' tabindex='28'   aria-required='true'    \/>\n                                    <label for='input_107_14_3' id='input_107_14_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_107_14_4_container' >\n                                        <input type='text' name='input_14.4' id='input_107_14_4' value='' tabindex='30'     aria-required='true'    \/>\n                                        <label for='input_107_14_4' id='input_107_14_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_107_14_6_container' >\n                                        <select name='input_14.6' id='input_107_14_6' tabindex='32'  aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' selected='selected'>United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_107_14_6' id='input_107_14_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_107_38\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Registration for Emergency Cardiology<\/h3><\/div><div id=\"field_107_4\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_107_4'>Registration Category<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_107_4'>The Emergency Cardiology Symposium 2026 is FREE to everyone who wishes to participate.\n\n\nFor those that would like a Certificate of Participation sent to them after the event we have added this option for $15.\n\nCME is offered at $150 for physicians only.<\/div><div class='ginput_container ginput_container_select'><select name='input_4' id='input_107_4' class='medium gfield_select' tabindex='33' aria-describedby=\"gfield_description_107_4\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='0' selected='selected'>FREE Registration (No CME)<\/option><option value='15' >Certificate of Participation $15<\/option><option value='150' >CME Certificate (MD, DO) $150<\/option><\/select><\/div><\/div><div id=\"field_107_8\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_107_8'>Registration FREE Backend<\/label><div class='ginput_container ginput_container_select'><select name='input_8' id='input_107_8' class='medium gfield_select' tabindex='34'    aria-invalid=\"false\" ><option value='14482' selected='selected'>FREE Registration<\/option><\/select><\/div><\/div><div id=\"field_107_41\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_107_41'>Registration COP Backend<\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_107_41' class='large gfield_select' tabindex='35'    aria-invalid=\"false\" ><option value='14484' selected='selected'>COP Registration<\/option><\/select><\/div><\/div><div id=\"field_107_33\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_107_33'>Registration CME Backend<\/label><div class='ginput_container ginput_container_select'><select name='input_33' id='input_107_33' class='medium gfield_select' tabindex='36'    aria-invalid=\"false\" ><option value='14483' selected='selected'>CME Registration<\/option><\/select><\/div><\/div><div id=\"field_107_43\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Communication<\/h3><\/div><fieldset id=\"field_107_32\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >How did you  hear about this conference?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_107_32'>Please check all that apply.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_107_32'><div class='gchoice gchoice_107_32_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.1' type='checkbox'  value='Email'  id='choice_107_32_1' tabindex='37'  aria-describedby=\"gfield_description_107_32\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_107_32_1' id='label_107_32_1' class='gform-field-label gform-field-label--type-inline'>Email<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_32_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.2' type='checkbox'  value='Internet search'  id='choice_107_32_2' tabindex='38'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_32_2' id='label_107_32_2' class='gform-field-label gform-field-label--type-inline'>Internet search<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_32_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.3' type='checkbox'  value='Twitter'  id='choice_107_32_3' tabindex='39'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_32_3' id='label_107_32_3' class='gform-field-label gform-field-label--type-inline'>Twitter<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_32_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.4' type='checkbox'  value='Podcast'  id='choice_107_32_4' tabindex='40'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_32_4' id='label_107_32_4' class='gform-field-label gform-field-label--type-inline'>Podcast<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_32_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.5' type='checkbox'  value='Referral'  id='choice_107_32_5' tabindex='41'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_32_5' id='label_107_32_5' class='gform-field-label gform-field-label--type-inline'>Referral<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_32_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.6' type='checkbox'  value='I have attended Conference in the past'  id='choice_107_32_6' tabindex='42'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_32_6' id='label_107_32_6' class='gform-field-label gform-field-label--type-inline'>I have attended Conference in the past<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_107_32_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.7' type='checkbox'  value='Other'  id='choice_107_32_7' tabindex='43'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_107_32_7' id='label_107_32_7' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_107_30\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_107_30'>Would you like to receive emails about other University of Maryland Department of Emergency Medicine education events?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_30' id='input_107_30' class='medium gfield_select' tabindex='44'   aria-required=\"true\" aria-invalid=\"false\" ><option value='Yes, please add me to the mailing list.' >Yes, please add me to the mailing list.<\/option><option value='No, I would only like to receive emails pertaining the Emergency Cardiology Symposium' >No, I would only like to receive emails pertaining the Emergency Cardiology Symposium<\/option><\/select><\/div><\/div><div id=\"field_107_44\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Payment Information<\/h3><\/div><div id=\"field_107_22\" class=\"gfield gfield--type-coupon gfield--input-type-coupon field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gf_coupon_code_107'>Coupon<\/label><div class='ginput_container' id='gf_coupons_container_107'><div class='ginput_container_coupon'><input id='gf_coupon_code_107' class='gf_coupon_code' onkeyup='DisableApplyButton(107);' onchange='DisableApplyButton(107);' onpaste='setTimeout(function(){DisableApplyButton(107);}, 50);' type='text'    tabindex='45'\/><input type='button' disabled='disabled' onclick='ApplyCouponCode(107);' value='Apply' id='gf_coupon_button' class='button'  tabindex='46'\/> <img style='display:none;' id='gf_coupon_spinner' src='https:\/\/cms.umem.org\/wp-content\/plugins\/gravityformscoupons\/images\/spinner.gif' alt='please wait'\/><\/div><div id='gf_coupon_info'><\/div><input type='hidden' id='gf_coupon_codes_107' name='input_22' value=''  \/><input type='hidden' id='gf_total_no_discount_107'\/><input type='hidden' id='gf_coupons_107' name='gf_coupons_107' value='' \/><\/div><\/div><div id=\"field_107_11\" class=\"gfield gfield--type-product gfield--input-type-calculation gfield_visibility_hidden gfield_price gfield_price_107_11 gfield_product_107_11 gfield_calculation field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_107_11_1'>Total<\/label><div class='ginput_container ginput_container_product_calculation'>\n\t\t\t\t\t<input type='hidden' name='input_11.1' value='Total' class='gform_hidden' \/>\n\t\t\t\t\t<div id='ginput_product_price_107_11' class='ginput_product_price_wrapper'>\n\t\t\t\t\t\t<span class='gform-field-label gform-field-label--type-sub-large ginput_product_price_label'>Price:<\/span>\n\t\t\t\t\t\t<span class='gform-field-label gform-field-label--type-sub-large ginput_product_price' id='input_107_11'>$0.00<\/span>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t<input type='hidden' name='input_11.2' id='ginput_base_price_107_11' class='gform_hidden ginput_calculated_price' value='$0.00'\/>\n\t\t\t\t\t<input type='hidden' name='input_11.3' value='1' class='ginput_quantity_107_11 gform_hidden' \/>\n\t\t\t\t<\/div><\/div><div id=\"field_107_45\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_107_45'>User Login<\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_107_45' type='text' value='' class='large'   tabindex='47'   aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_107_27\" class=\"gfield gfield--type-password gfield--input-type-password gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Password<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_107_27'>Set a password to access the online portal<\/div><div class='ginput_complex ginput_container ginput_container_password gform-grid-row' id='input_107_27_container'>\n\t\t\t\t\t\t<span id='input_107_27_1_container' class='ginput_password ginput_left gform-grid-col gform-grid-col--size-auto'>\n\t\t\t\t\t\t\t<span class='password_input_container'>\n\t\t\t\t\t\t\t<input type='password' name='input_27' id='input_107_27'   aria-describedby=\"gfield_description_107_27\" value='' tabindex='48'  aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t\t\t\t<button type='button' class='gform_show_password 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left;\"><span style=\"color: #000000;\"><span class=\"fontstyle0\">This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the University of MD Emergency Medicine.\u201d <\/span><\/span><\/p>\n<p style=\"text-align: left;\"><span style=\"color: #000000;\"><span class=\"fontstyle0\">\u201cThe Center for Emergency Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.\u201d<\/span><\/span><\/p>\n<p style=\"text-align: left;\"><span style=\"color: #000000;\"><span class=\"fontstyle0\">The Center for Emergency Medical Education designates this live activity for a maximum of 3.5 <\/span><span class=\"fontstyle2\"><em>AMA PRA Category 1 Credits<\/em>\u2122. <\/span><span class=\"fontstyle0\">Physicians should claim only the credit commensurate with the extent of their participation in the activity.<\/span><\/span><\/p>\n<p><span style=\"color: #000000;\"><span style=\"color: #993300;\"><strong>NPs, RNs, LPNs, and PAs:<\/strong><\/span>\u00a0You may claim a certificate of participation. ANCC and AAPA accept medical\u00a0<em>AMA PRA Category 1 Credits<strong>\u2122\u00a0<\/strong><\/em>for nursing and physician assistant re-licensure.<\/span><\/p>\n<\/div><\/div><\/div><\/div><div class=\"x-section e12093-e20 m9bx-0 m9bx-2\"><div class=\"x-row x-container max width e12093-e21 m9bx-3 m9bx-5 m9bx-7\"><div class=\"x-row-inner\"><div class=\"x-col e12093-e22 m9bx-8 m9bx-9\"><div id=\"\" class=\"x-text\" style=\"\" ><h4 style=\"text-align: center;\"><span style=\"color: #000000;\">Questions?<\/span><\/h4>\n<div style=\"text-align: center;\">\n<div><span style=\"color: #000000;\">Please contact<\/span><\/div>\n<div><strong><span style=\"color: #000000;\">Doreen Lucadamo, CMP, DES, HMCC<\/span><\/strong><\/div>\n<div><span style=\"color: #000000;\"><em>Senior Program Coordinator, Courses\/Conferences <\/em><\/span><\/div>\n<\/div>\n<\/div><div id=\"\" class=\"x-text\" style=\"\" ><div style=\"text-align: center;\">\n<div><a data-cke-saved-href=\"mailto:dlucadamo@som.umaryland.edu?subject=PUG%20Course%20Information%20-%20Website\" href=\"mailto:dlucadamo@som.umaryland.edu?subject=PUG%20Course%20Information%20-%20Website\">dlucadamo@som.umaryland.edu<\/a><span> \u2666 Phone: 443-562-8630<\/span><\/div>\n<\/div>\n<div style=\"text-align: center;\"><span style=\"color: #000000;\">University of Maryland School of Medicine \u2666 Department of Emergency Medicine<\/span><\/div>\n<div style=\"text-align: center;\"><span style=\"color: #000000;\"> <\/span><span style=\"color: #000000;\">110 S. Paca Street,\u00a0<\/span><span style=\"color: #000000;\">Sixth Floor, Suite 200,\u00a0<\/span><span style=\"color: #000000;\">Baltimore, MD 21201<\/span><\/div>\n<\/div><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Registration &#038; CME InformationIMPORTANTHave you been to Crashing Patient, Emergency Cardiology Symposium, or Critical Care Symposium since 2020? If so please LOGIN before completing the registration form or you will &#8230; <\/p>\n<div><a href=\"https:\/\/cms.umem.org\/index.php\/emergency-cardiology-symposium-2026\/ecs26-registration\/\" class=\"more-link\">Read More<\/a><\/div>\n","protected":false},"author":4903,"featured_media":0,"parent":14411,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-blank-4.php","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-12093","page","type-page","status-publish","hentry","no-post-thumbnail"],"_links":{"self":[{"href":"https:\/\/cms.umem.org\/index.php\/wp-json\/wp\/v2\/pages\/12093","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cms.umem.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/cms.umem.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/cms.umem.org\/index.php\/wp-json\/wp\/v2\/users\/4903"}],"replies":[{"embeddable":true,"href":"https:\/\/cms.umem.org\/index.php\/wp-json\/wp\/v2\/comments?post=12093"}],"version-history":[{"count":18,"href":"https:\/\/cms.umem.org\/index.php\/wp-json\/wp\/v2\/pages\/12093\/revisions"}],"predecessor-version":[{"id":14615,"href":"https:\/\/cms.umem.org\/index.php\/wp-json\/wp\/v2\/pages\/12093\/revisions\/14615"}],"up":[{"embeddable":true,"href":"https:\/\/cms.umem.org\/index.php\/wp-json\/wp\/v2\/pages\/14411"}],"wp:attachment":[{"href":"https:\/\/cms.umem.org\/index.php\/wp-json\/wp\/v2\/media?parent=12093"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}