"What's Your Plan?" Event REGISTRATION
This is solely used for registration in the upcoming "What's Your Plan?" Information Session (or our SPECIAL PRESENTATION at HOSPITAL MARINA) in Mazatlan and to include you in our mailing list for any future events. (We hate SPAM too and will not sell or share your information with anyone.)
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Full Name *
Partner / Spouse Full Name *
(enter NONE if applicable)
Email Address (for confirmation) *
Mazatlan Contact Number (in the event of any venue changes) *
(Cell, home)
Secondary Contact Number
(VONAGE or Magicjack)
I wish to attend the following event: *
(If location not stated below, it will be sent out via email when confirmed)
I will be attending this session with the person who has an interest in my health and well being. *
As we will be covering a lot of information, it is best that anyone involved in the decision making process attend the session with you. If this is not possible, we highly recommend you attend the next session instead or contact us for a personal appointment at a time that is more convenient for both of you. (travelmedevacmaz@gmail.com)
I am a resident of: *
*you spend at least 6 out of 12 months of the year in...
I learned about this event through: *
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