Myofascial Palpation – the Cornerstone of Diagnostic Acumen Registration Myofascial Palpation - the Cornerstone of Diagnostic Acumen Registration Step 1 of 3 33% Registrations are accepted from qualified applicants. Registration will be open and ongoing. Basic InformationName* First Last Title MD DO PT RN NP DTCM FIAMA LAc DOM RAc Other If 'Other,' please provide your title hereName for Certificate of Completion (including degrees)*College and Year of Graduation*State Where LicensedLicense Number (upload a copy of your license below)Upload a copy of your current medical license. You will be enrolled in the course once this has been received, reviewed, and accepted.Accepted file types: pdf, jpg, png, .Formats accepted are pdf, jpg, png. The file will upload when you submit the form. 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Home Work Work PhoneCell PhoneEmail Address (preferred for course material)* Terms and Conditions Returned Check Policy There will be a $35 fee for checks returned for insufficient funds and course will be suspended until payment clears. Cancellation Policy CuraCore reserves the right to cancel the course. A full refund will be given if the course is cancelled. No refunds will be granted once you have started the course. I understand that by submitting this registration form and the course registration fee is non-refundable per policy. I have read, understood, and agree to the terms and conditions contained herein. I further understand that by signing below, I have reviewed and agree to the course curriculum, subject to such changes as may be approved by CuraCore. Type your name in here to indicate that you agree to the terms outlined above*End User Agreement* I agree. Note: By clicking "I Agree" you acknowledge that you have read and agree to the terms set forth in the end user agreement. You must read the linked document and check the box above to continue with the form.Additional ItemsSign Up for Our Course Announcements Sign me up! Program SelectionCourse FeeMyofascial Palpation - the Cornerstone of Diagnostic Acumen $0.00Coupon Total $0.00 Will you be paying by credit card or check?*Credit CardCheck in US dollars (mail to CuraCore, 905 S Summit View, Fort Collins, CO 80524) Note: If paying by credit card, you will be asked to enter your billing address separately when checking out.If paying by check, please make payment to "CuraCore" and mail to: CuraCore 905 S Summit View Fort Collins, CO 80524 Questions? Contact us at firstname.lastname@example.org or 970-818-0851.NameThis field is for validation purposes and should be left unchanged.