" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

Practical Documentation, Billing, Coding,
and Compliance for Interventional Pain Practices
October 9-11, 2009

The Peabody Memphis :: 149 Union Ave
Memphis, TN 38103 :: (901) 529-4164

Attendee Information:
First Name: Middle Initial:
Last Name: Title:
Organization: Address:
City: State:
Zip: Country:
Phone: Fax:
Cell: E-mail:
Date of Birth:   Male Female
Comprehensive Review Course in Coding, Compliance and Practice Management
American Society of Interventional Pain Physicians: Registration Dates
Registration Fee for Courses: Payment on or before 09/14/09 Payment after 09/14/09
Review Courses: (CCPM)
Comprehensive Review Course
$600 $800
Comprehensive Review Course
$800 $1,000
Fellow Discount (Click here only if you are currently
in a pain fellowship program to receive discount )
50% Discount 50% Discount
Payment Method
Mastercard | Visa | Discover | American Express
Card Number: Exp. Date:
Cardholder's Name: Security Code:

Cancellation Policy:

ASIPP reserves the right to cancel this workshop upon reasonable notice and will assume no financial obligation to registrants for cancellation for reasons beyond its control. Registration fees will be refunded. However, costs incurred by the registrants, such as airline or hotel fees or penalties, are the responsibility of the registrants. Registrants who are not accepted into this workshop will receive notice by mail with their returned check. ASIPP requires a 30-day notice of cancellation. Cancellations must be submitted in writing and received by September 14, 2009. An administrative fee of $200 will be assessed. Cancellations after September 14, 2009 but prior to September 25, 2009 will forfeit 50% of their registration fee. No cancellations accepted after September 25, 2009. Refunds will be sent after the conclusion of the meeting.

All contents Copyright © 2009
American Society of Interventional Pain Physicians ®
81 Lakeview Drive, Paducah, KY 42001
Phone 270.554.9412, Fax 270.554.5394
E-mail asipp@asipp.org