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Trauma and Critical Care Conference

To register for the San Juan Regional Medical Center Trauma and Critical Care Conference please complete the form below.

The conference will run for two days:

Wednesday, October 25, 2023

Thursday, October 26, 2023 

Location: Farmington Civic Center
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Email
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Last Name
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First Name
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Address

ex. 111, Smith Street, apt. 111
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City
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State
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Zip Code
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Telephone Number

xxx-xxx-xxxx
Additional Attendees
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Conference Fees. $250
I will be paying by check.
Pay by check or PO: Please mail your check  with check payable to, SJRMC Trauma Conference:
Attn: Robbie Donald
San Juan Regional Medical Center AirCare and Trauma
801 West  Maple Street
Farmington, NM 87401


Enter your PO number in the text box below.
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I will be paying for this conference in advance with a credit card
Card Type
First Name
Last Name
Card Number
CVC Code
Expiration Date (month/year)
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Type of CE
SUBMIT
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