RESERVATION FORM
LIBERTY CE PROGRAMS

Use a SEPARATE reservation form for each person.

Name:
Office Address:
City, State, Zip Code:
Telephone #:
Fax #:
Email Address:

View More Detailed Program Information

Registration Information

Please Note:

  • Refunds must be requested IN WRITING. There will be a 25% administrative charge on all cancellations.
LC 31 - Cover Your Assets $45.00
LC 32 - Medical Emergencies $40.00
LC 33 - Materials & Techniques in Fixed Prosthodontics $45.00
LC 34 - Infection Control $35.00
LC 35 - Understanding Current CDT Codes $40.00
LC 36 - Practice Transitions $35.00
LC 37 - Endodontics for the General Practitioner $30.00
LC 38 - Musculoskeletal Injuries $45.00
LC 39 - The Dental Career: Young Dentists $35.00
LC 39 - The Dental Career: Young Dentists (dental students, postgraduate & residency students, recent graduates) $0.00
LC 40 - Effective Claims Submission $40.00
LC 41 - PLI Risk Management Seminar $40.00
LC 42 - Street Smarts: Patient Substance Abuse $45.00
LC 43 - Ballpark Tours:
Indicate preferred time:
Total number of people
$5.00

CE Package Credit

If you are registered for the Society's CE package, you may choose 2 courses at no charge. Please select the two courses that you have already selected above from the list below so that they will be deducted from the total price. These charges will be deducted from the Total Payment box.

Yes, I have registered for the CE package.

Payment Information

Subtotal
CE Package Credit
Total Payment
CC Account #
Credit Card Type
Expiration Month
Expiration Year

The Philadelphia County Dental Society neither expresses nor implies that specific courses will fulfill various state continuing education requirements.
Consult the regulations pertaining to the requirements of your state.


Philadelphia County Dental Society
241 South 6th Street, Philadelphia, PA 19106
Telephone: (215) 925-6050 Fax: (215) 925-6998

General Information, Questions, Comments: info@philcodent.org
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