2023 Doc Mac Wellness Conference - Tennessee Dental Wellness Foundation

Registration for this year’s Dr. Mac Wellness Conference is now available. Please use the form below to reserve your spot.

Name*
First Last
Address*
Please use the address associated with your credit card.

Street Address Address Line 2 City State ZIP Code
Phone
Cell Phone
Personal Email
Is Your Spouse/Significant Other Planning to Attend?
- Yes ($45)
- No
The cost is $45 for your spouse/significant other to attend.
Spouse/Significant Other Name
First Last
Only necessary if they're attending.
Select One*
- Dentist ($205)
- Dental Hygienist ($95)
- Dental Assistant ($95)
- Other – Board Member, Spouse/Significant Other
Please enter your designation if you selected other.
Would you like to make a donation or sponsor an attendee?*
- Yes
- No
Donation/Sponsorship
Total
$0.00
(You will receive 6 hours of continuing education.)
Credit Card*

Discover
MasterCard
Visa
Supported Credit Cards: Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
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