Your Registration

Online Registration is only for new customers; if you are an existing member please register through your member's portal.


Advanced Botox and Dermal Fillers (Level II)	$1,199.00 Discount already applied!
May 10 2021 Orlando, FL Hilton Orlando Lake Buena Vista

Botulinum Toxin Training	$1,199.00 Discount already applied!
Mar 28 2021 New York City, NY Intercontinental NEW YORK Times Square

Advanced Botox and Dermal Fillers (Level II)	$1,399.00 Discount already applied!
Oct 02 2022 Las Vegas, NV Las Vegas Marriott

Botulinum Toxin Training	$699.00 Discount already applied!
Jan 22 2022 AAOPM-Virtual-Training Hotel to be announced

Sexual Dysfunction Training for Men and Women	$699.00 Discount already applied!
Feb 28 2022 AAOPM-Virtual-Training LiveStream / Online Training

Advanced Botox and Dermal Fillers (Level II)	$699.00 Discount already applied!
Jun 06 2022 AAOPM-Virtual-Training LiveStream / Online Training

Allergy Test and Treatment	$699.00 Discount already applied!
Jun 10 2022 AAOPM-Virtual-Training LiveStream / Online Training

Botulinum Toxin Training	$1,399.00 Discount already applied!
May 06 2023 Kansas City, MO Westin Hotel at Crown Center

empty cart Registration: $7,992.00 Credit Card Convenience Fee: $239.76 Total Amount Due: $8,231.76

1 - Customer Information

First Name:

Last Name:

Medical Title:

Email Address:

Telephone:

Are you a Practice Owner?:

State License #:

Name of Account Rep who guided you, if any:

2 - Payment Information

eCheck Payment

Account Type:

Bank (Institution) Name:

Routing Number:

Account Number:

Name on Account:

Amount to be Charged:

Date:

Email for Confirmation:

I (we) understand that this authorization will remain in full force and effect until I (we) notify AAOPM, INC. in writing at the following:

AAOPM, Inc.
2720 East Oakland Park Blvd, #102
Fort Lauderdale, FL 33306
(954) 525-4273
(954) 358-2860 (F)

That I (we) wish to revoke this authorization.

Name(s):

Date:

eSignature: (Please type your full name)

Credit Card Payment
(3% Convenience fee ($239.76))

Card Type:

Credit Card Number:

Expiration Date:

CVV:

3 - Billing Information

Address:

Address 2:

City:

Country:

State:

Zipcode:

I acknowledge that I have read and agree with the AAOPM terms of service, privacy policy, and cookie policy. California courses attendees: In order to inject during hands-on sessions, you need to be licensed to inject in California.

Amount to be charged: $8,231.76