Register

  • First Name:
      Your First Name.
    *
  • Last Name:
      Your Last Name.
    *
  • Email Address:
      Your email address.
    *
  • Confirm Email:
      Re-type your email address.
    *
  • Specialty:
      Select your specialty like Anesthesia,
      Pediatrician, Nurse etc.
    *
  • Place of Practice [Name of Institution]:
      Name of hospital, institution or affiliation.
    *
  •  
      Enter Academic or Non-Academic.
    *
  •  
      Place of Practice.
    *
  • Educational Background:
      Educational Background - Physician(MD, DO, DMD)
      or Non-physician
    *
  • City:
      City of practice.
    *
  • Country:
      Country of practice.
    *
  • Mobile or Office Phone:
      Enter your mobile or office phone number.
    *
  • Number of Sedations Performed in a year:
      Number of sedations which you (registrant) personally perform or supervise in a year
    *
  • Predominant Patient Population:
      Predominant patient population for
      sedation-pediatric, adult or mixed.
    *
  • Create a User Name:
      Must contain minimum 4 characters.
    *