Registration - Racz Lab

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Superior Training for Minimally Invasive Pain Management Procedures

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Racz Interventional Pain Workshop » Registration

RACZ WORKSHOP REGISTRATION

Welcome to the registration page for Interventional Pain Workshop of Minimally Invasive Pain Management Procedures, otherwise known as Racz Lab or Racz Workshop. The lab provides lecture and didactic training for pain physicians across the globe. Registration takes approximately 5-10 minutes.

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First Name*
Last Name*
Titles*
Phone*
Practice Name*

Medical School*
Residency*
Fellowship*
Glove Size*

How did you hear about Racz Lab?*
Please specifiy how you heard about Racz Lab:*
What are you interested in learning at the workshop?*
What do you hope to gain while at the workshop?*

Medical Degree*
- MD
- DO
- PHD
- Other Medical Degree
Other Medical Degree*
Current Board Certifications*
- American Board of Anesthesiology
- American Board of Pain Medicine
- American Board of Psychiatry and Neurology
- American Board of Physical Medicine & Rehabilitation
- ABA Subspecialty in Pain Medicine
- Fellow of Interventional Pain Practice (FIPP)
- American Board of Interventional Pain Physicians (ABIPP)
- Other Board Certifications
Other Current Board Certifications*
Specialty Designation*
- Radiology
- Physical Medicine & Rehab
- Anesthesiology
- Neurosurgery
- Neurology
- Other Specialty
Other Specialties*
Primary professional practice setting(s)*
- Ambulatory Surgery
- Hospital
- Office Practice
- Academic
- Administrative
- Military / VA
- Other Practice Setting(s)
Other Practice Setting*
Which interventional techniques do you perform at your practice?*
- Epidural Injections
- Cervical Neuroplasty
- Lumbar Neuroplasty
- S1 Neuroplasty
- Spinal Cord Stimulation
- Catheter Injections
- Nerve Blocks
- Suboccipital Decompression
- Radiofrequency
- Vertebralplasty/Kyphoplasty
- Cryoanalgesia
- Other Techniques
Other Techniques*

What percentage of your clinical practice is in the field of Interventional Pain Management?*
- 0%
- 1-49%
- 50-100%
Years in Interventional Pain Management*
- 0
- 1-5
- 6-10
- 10+
Meal Preference*
- Vegetarian
- Vegan
- None
Allergies*
- Milk
- Soy
- Nuts
- Gluten
- None
- Other Allergies
Other Allergies*

Credit Card Billing Address*
Credit Card Billing Address 2
City*
State Province*
Postal Code*
Country*
Credit Card*

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Visa
Supported Credit Cards: American Express, MasterCard, Visa
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Purchase Terms and Conditions*
I have read and agree to the site's Cancellation, Terms of Use, and Privacy Policies.
*Space is limited. Please register ASAP.
*Registrants are screened and pre-qualified.
*Only physicians may attend a workshop.
*The fee is non-refundable.
*In most cases for in-person, non-virtual events, attendance must be confirmed 30 days prior to the workshop date.
*For in-person, non-virtual events, attendee is responsible for their own air travel, hotel, and transportation.

PLEASE NOTE: For in-person, non-virtual events, attendees who fall ill before or during the event, will be asked to leave for the safety and well-being of others in attendance.

Cancellations:
In most cases, for in-person, non-virtual events, attendance will be verified at least 30 days prior to the workshop date. The workshop fee is non-refundable for approved applicants, regardless of attendance. In rare cases in which an applicant does not qualify to attend a workshop, a 100% refund will be issued. Refunds can take up to 30 days to process.

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