Registration for the Pediatric Certificate Program

SOT® Pediatric Certificate Program

Each in-person seminar is 16 hours long and runs from 9 a.m. to 6 p.m. on Saturday and Sunday.

Registration is complete after payment is received.
You'll be redirected to checkout after submitting this form.
Each registration is personally reviewed by Dr. Martin Rosen and Dr. Nancy Watson.

First Name

Last Name

What School?

Professional Degree:

Chiropractor or Student?

Chiropractor

Student

Other

Office Name

Address

Address Line 2

City

State

Zip Code

Country

Office Phone

Fax

Home Phone

Mobile Phone

Website

What do you hope to get out of this course?

How did you hear about us?

CE Credit Requested?

Yes

CE Credit State

Chiropractic License Number

Chiropractic License State

NPI Or Social Security Number

Form submission[]

There are no refunds once you are accepted into the course