Conference Registration

2019 Conference Registration

Attendee Information

First Name
Last Name
Enter Email
Confirm Email
Street Address, Apt Number, Suite Number
i.e. MD, PA, ND, NP, Lac, Chiropractor, Health Coach, Nutritionist

Conference Information

Make your check payable to "MCIM" and mail to: Midway Center for Integrative Medicine, Attn: Jennifer, P.O Box 277, Midway, KY 40347