Complete and submit the "Preliminary Application Form" below – or print out this page, fill it out and FAX it to us at (954) 967.6553. There is no obligation and no fees are required. If you have questions, feel free to call us at 954-967-6550 and ask for the VeinwoRx Program Director.
Testimonials
"Thank you for the great experience."
"I very much enjoyed the day at your office for endovenous ablation training and found it to be of immense value."
"I found the experience extremely enjoyable and helpful."
"An excellent experience with knowledgeable operators and friendly, expert staff."
Once we have received your Preliminary Application Form we will call you to discuss your wishes and establish the type of training you wish to have.
Upon completion of our phone call we will FAX you a "Confirmation Form" which will indicate the type of training you will have, fees, dates and other information about your course. At this time we will assist you with lodging accommodations, travel, etc.
Then, if everything meets your satisfaction simply sign the completed "Confirmation Form" and return it via FAX along with your credit card information and you will be registered. We collect a non-refundable $500 deposit with the "Confirmation Form". Should you need to cancel or reschedule your preceptorship, your deposit will apply to your future date.
Final payment is due anytime prior to the programs beginning. We will call you and ask your permission to submit your final payment on your credit card.
Upon final payment we will send you the programmed instruction material.
Preliminary Application Form
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