Page 1 of 2

Conference Head Count

We're gauging interest in a conference this fall (a Thursday evening through Saturday in mid-October to early November, likely in the midwest, possibly Ohio).

Please answer below—this is not a commitment to register, just a read on interest.

How likely are you to attend?

*

A

Very likely

B

Somewhat likely

C

Only if [specific topics/speakers]

D

Not this year

Including yourself, how many people from your organization would likely attend?

*

Which track interests you most?

*

A

Admin

B

Clinical

C

Both / would split my team across tracks

Would you attend a full day dedicated to wellness?

*

A

Yes, very interested

B

Maybe

C

No

Pricing. Registration is $1,199, with discounts that stack:

*

$200 off for members $100 off early-bird (through August) $200 off each additional person, 3rd and beyond, in a group

Example: a member registering early pays $899. A 3rd+ group member who is also an early-bird member pays $699.

At these prices, how do you feel about attending?

A

Reasonable—I'd register

B

A stretch but doable

C

Too high for me

D

Need to see the agenda first

Comments, questions, complaints, ideas

*

Name

*

Organization

*

Email

*

Phone

*