Registration information is limited to the Primary Doctor per Practice.

Products   Price Quantity Total
Platinum Membership

Platinum Membership

$800.00 1 $800.00
Platinum Monthly Dues

Platinum Monthly Dues

$195.00/ month
$195.00 1 $195.00
Subtotal $995.00
Order Summary
Subtotal
$995.00
Total Due
$995.00
Billing Information
Payment
 Credit Card