Registration information is limited to the Primary Doctor per Practice.

Products   Price Quantity Total
Membership Fee - Gold Member

$250.00 / month for 4 months

$250.00 1 $250.00
Gold Monthly Dues

Gold Monthly Dues

$195.00/ month
$195.00 1 $195.00
Subtotal $445.00
Order Summary
Subtotal
$445.00
Total Due
$445.00
Billing Information
Payment
 Credit Card