Name
Professional Degree
How did you hear about the conference?

Conference Fees

The $175 registration fee covers all materials; lunch is provided (Registration fees increase to $200 on March 15, 2019.)

*No Charge For:
- Paid faculty of the Department of Family & Community Medicine
- Primary investigators on accepted posters approved by Malvika Juneja, M.D.
- All medical students approved by Bridget Angel
- All residents approved by Eric Warwick, M.D.
- All fellows approved by Jason Salemi, Ph.D., MPH
- Family & Community Medicine clerkship preceptors approved by William Huang, M.D.

**Reduced Fees - 50 percent off for:

- PPS Preceptors of 1st-year students, approved by Alicia Kowalchuk, D.O.
- All Baylor volunteer faculty
- DDASH-IAT facilitators, approved by Malvika Juneja, M.D.
- Healer's Art facilitators, approved by Joy Blumenreich, M.D.
- Baylor faculty of other departments

Conference Fee - Select fee that applies to you

Payment Information

Payment can be made with credit card, or personal check/cash.

- For credit card payments, upon submission of your registration, you will be taken to an online credit card form.

- For check payments, Please make payable to Baylor College of Medicine, with PCU Registration in the memo section. Please feel free to drop off or mail check and cash payments in advance addressed to:

Daniela Moreno
BCM-FCM
3701 Kirby Dr. Suite #600
Houston, TX 77098