11th Annual "Neuropathy Action Awareness Day"
Friday, June 23, 2017
Intercontinental Hotel, Los Angeles

Please complete this registration form and the payment page. Your registration will be acknowledged by email. THANK YOU! (REGISTER BEFORE JUNE 16 TO AVOID A $50 CHARGE)
Please check off which events you will attend:
In addition, the following guests will attend:
*Please provide the information below: (Type as you wish your name to appear in print)

Click "Continue" below to review your order and payment options.

Cancellation Policy: You may cancel or change your registration up to 7 days prior to the meeting (on or before June 16, 2017) without penalty. You will receive a full refund promptly. Cancellations for any reason received after June 16, 2017 cannot be refunded. No shows are not refundable.

NEED HELP: Please call or email us at (877) 512-7262 (info@neuropathyaction.org) for assistance. Thank you.