2016 Otolaryngology White Coat Wednesday at the Legislature presented by NCSOHNS and NCMS

Sign up for one (or both!) 2016 Otolaryngology White Coat Wednesdays.

Sign up now to participate in a 2016 Otolaryngology White Coat Wednesday! ENT physicians from across the state will gather in Raleigh on two Wednesdays in May - May 18 and 25 – to advocate for Certificate of Need reform and other important policy issues impacting your practice and patient care. There is no fee to participate. Practicing otolaryngologists, practice managers, retired physicians, residents and fellows-in-training are invited to participate.

The schedule runs from 7:30 am to 1:00 pm (lunch is provided). Following a legislative briefing at the NC Medical Society, participants will meet with legislators and attend legislative committee hearings at the NC General Assembly. We’ll have you on the road home by 1:00pm (earlier, if necessary).

Complete this sign-up form to participate on the May 18 and/or the May 25 Otolaryngology White Coat Wednesday. Not available either date? You can also use this form to indicate the date that works best for your schedule.

This event is jointly presented by the NCSOHNS and the NC Medical Society.

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* 1. I will participate on:

Wednesday, May 18

Wednesday, May 25

Both dates.

I am not available either day. This is the date that works for me:

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* 2. Contact Information

Name

Home Address

City/Town

ZIP/Postal Code

Email Address

Cell Phone Number*

* Your cell phone number will be used to communicate any last minute schedule changes on the day of the meeting. Your meeting schedule will be subject to change right up to the very last minute due to the fluid environment at the legislative building.

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* 3. Please indicate any dietary restrictions, schedule limitations or other requests:

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* 4. Current residents and fellows-in-training, please indicate your academic institution:

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* 5. Practice managers, please indicate the name of your practice.

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* 6. Local Meetings

I would like assistance coordinating local meetings with legislators.

Thank you for your participation and support of NCSOHNS! To make changes to your registration, please contact NCSOHNS' Denna Suko at dsuko@ncmedsoc.org or 919-833-3836.