Online Registration:
Marshfield Clinic Health System Behavioral Health Conference
Friday, April 11, 2025

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* Name (First and Last):

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* Degree (i.e. MD, PA, NP, CSW):

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* Organization Name:

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* Mailing Address:

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* City, State & ZIP:

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* Phone (Daytime):

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* Email Address:

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* If you are attending in person and have any dietary restrictions, please list them below:

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* I will attend the conference:

In person

Virtually

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* Registration Fee:

$100 (Physicians)

$50 (Allied Health Professionals & Others)

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* I will pay the registration fee by:

Check (make payable to Marshfield Clinic Health System and mail to Marshfield Clinic Health System; Conference Registration-GR; 1000 N Oak Ave; Marshfield WI 54449)

Credit Card, please call 715-389-3776 to make payment (Marshfield Clinic Health System accepts MasterCard, VISA, American Express, Discover)

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* Thank you for your registration. If you have any comments, please list them below. Click on the Submit Registration button.