2018 ATTENDEE REGISTRATION

Get Your Pass Here

Pacific Symposium will be taking place from Tuesday, October 23 through Tuesday, October, 30 2018. Set in a beautiful retreat setting at the Catamaran Resort and Spa in San Diego, California, Pacific Symposium not only promises aesthetics, but guarantees cutting edge speakers at the forefront of the integrative health community. In addition to groundbreaking seminars and hands-on workshops, don’t miss our Exhibit Halls with over 50 vendors and premium quality holistic health companies. With a wide range of products, discounts, and even some wholesale prices, our annual Exhibit Hall is an incredible opportunity. PCOM Faculty click here.

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Attendee Registration
Personal Information

* Please note that as an Alum, you will be earning CEUs/PDAs

* Please note that as a Student, you will be not earning CEUs/PDAs

* Please note that as a Student, you will be not earning CEUs/PDAs

*Please note that as Faculty, you will be earning CEUs/PDAs

First Name
Last Name
Password
Phone Number
Address Line 1
Address Line 2
City
International Attendees
Country
Zip Code
What year did you start?
What School Do You Attend?
What year did you Start?
What year did you start?
Acupuncture License Number - Main
Acupuncture License Number - Other
Registration Options
Additional Options

PCOM Alumni Save 10% off the total price!

College Students Save 50% off the total price!

PCOM Students Save 70% off the total price!

Your Price: $

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Payment Information

Pacific Symposium Accepts:

  



Enter Credit Card Details:

$[ field5* (field102 + field55 + field56 )]
Terms and Conditions *

INFORMED CONSENT TO TREATMENT


I hereby request and consent to the performance of acupuncture treatments and other procedures associated with Traditional Oriental Medicine by the Pacific Symposium and its guest speakers.


I understand that methods of treatment may include, but are not limited to: acupuncture, moxibustion, cupping, guasha, electrical stimulation, Tui-Na (Chinese Massage), Chinese herbal medicine, and nutritional counseling.


I have been informed that acupuncture is a generally safe method of treatment, but that it may have side effects, including bruising, numbness, or tingling near the needling sites that may last a few days, and dizziness or fainting. Burns and/or scarring are a potential risk of moxibustion, cupping and gua sha, or when a treatment involves the use of heat lamps. Bruising is a common side effect of cupping. Unusual risks of acupuncture include: miscarriage, nerve damage and organ puncture, including lung puncture (pneumothorax). Infection is another possible risk, although the Pacific Symposium uses sterile, disposable needles and maintains a clean and safe environment.


I understand that the Pacific Symposium is a teaching event; as such, I do not expect the Pacific Symposium staff and guest speakers to be able to anticipate and explain all possible risks and complications of treatment, and I wish to rely on clinicians to exercise judgment during the course of treatment which they think, based upon the facts then known is in my best interest. I understand that results are not guaranteed.


VIDEO, AUDIO TAPE, AND PHOTO CONSENT


By signing this Photo, Video and Sound Recording Release and Consent Form, you are irrevocably giving permission to the Pacific Symposium to take and use photographs, video or sound recordings of you during the course of the Symposium. This is completely voluntary and up to you.


Your consent to the use of the photographs, video and sound recordings and your image, likeness, appearance, and voice is for forever. You will not receive compensation for the use of your image, likeness, appearance, and voice now or in the future. The Symposium may use the photographs, video and sound recordings containing your image, likeness, appearance and voice in any manner or media, including use on web pages. The photographs, video and sound recordings may be used in whole or in part, alone or with other recordings. The photographs, video and sound recordings may be used for any educational, institutional, scientific or informational purposes whatsoever, but not for any commercial uses. All right, title, and interest in the photographs, video and sound recordings belong solely to the Pacific Symposium.


 By checking the box below, I show that I have read the consent to treatment, as well as the video, audio, and photo consent. I intend this consent form to cover the entire event of the Pacific Symposium for any demonstrations or practice sessions that I may choose to participate in.

Please review the inforation below. If correct, select I Agree and Charge My Card.


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I have read and agree to the above statements
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