Expanding the Practice of Integrative Medicine
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INTEGRATIVE WELLNESS ASSOCIATES
STEPHEN PANEBIANCO, MD
AMY PANEBIANCO, BA
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Tucson, AZ
520-820-5568
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Event Registration Form
Event Information
Please select the event you are registering for:
How did you learn about this event?
PAYMENT & CANCELLATION POLICY
First Name:
Personal Information
Last Name:
Gender:
Address:
City:
State:
Zip Code:
Best Phone #:
Email:
Our main form of communication is via email to conserve paper. We appreciate you providing an email address if possible.
Occupation:
Age Range:
What is your main area of interest for this seminar?
By clicking the submit button, I am registering
for the above listed event and agree and
accept the Payment & Cancellation Policy as described below. At the next screen, I will be
asked to submit my payment through
PayPal to secure my registration.
Secure Payment through
PayPal
Credit & Debit
Cards Accepted
Payment in full is required upon registration for seminars and classes. All payments are securely processed through PayPal using credit or debit cards. You will be asked for payment on the next screen after clicking the submit button. If you would prefer to mail a money order, please fill out the online registration form above and EMail Integrative Wellness Associates that you are mailing a money order. Please note the seminar title and date in your email and on the money order. Your registration will not be finalized until your money order is received.
Cancellations and requests for refunds must be made in writing either through EMail or regular mail. Please be aware of the following cancellation policies. These strict policies ensure your space at events.
Seminars- A full refund less a $40 processing fee will be issued for cancellations made 10 days prior to the event date. Refunds will not be issued for cancellations made after the above specified period.Classes- A full refund less a $25 processing fee will be issued for cancellations made48 hours prior to the date of the first class. Refunds will not be issued for cancellations made after the above specified period.Copyright © 2006, Integrative Wellness Associates, All Rights Reserved.
