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Convention Registration

This registration form is for doctors and medical assistants. This form is to register one individual. Please complete form separately for each additional registrant from your office.

An additional fee of $35 will be added to all registrations received after September 28, 2023. After September 28, complimentary registrations will increase to $35.

For assistance, call 888-330-5589.

First Name *

Last Name *

Credentials

Practice Name/DPM Name

Street Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Dietary Restrictions/Special Needs

Registration Fees *

IPMA Member ($295)

APMA Member ($495)

Non-Member ($795)

IPMA/APMA Life Member ($0)

Resident/Student ($0)

Medical Assistant/Office Staff ($130)

Registration Code

Attendance Options

Please indicate below how you will participate in the conference - all virtual or all in person. We regreat that we cannot offer a combined format of both virtual and in person.

There is an additional fee of $150 to attend virtually. This fee covers the additional costs to provide a virtual option to attend.

Select Attendance Option *

I will attend in person at the Marriott

I will attend virtually ($150 additional fee)

Doctors: Please help us plan for your attendance. Select the events that you will attend. *

Thursday Lunch Lecture

Thursday Afternoon Lectures

Friday Morning Lectures

Friday Lunch

Saturday Morning Lectures

Saturday Lunch

Sunday Resident Lectures

I am attending virtually

Medical Assistants/Staff: Please help us plan for your attendance. Indicate which of the following you will attend. *

Thursday Lunch Lecture (Included with registration)

Thursday Afternoon Doctor Lectures

Friday Assistant/Staff Lectures

Friday Lunch (Included with registration)

Saturday Doctor Lectures

Saturday Lunch (Additional fee of $35)

Saturday Lectures

Saturday Lunch *

Saturday Lunch Fee ($35)

Adult CPR/AED Certification Course - Thursday, October 5

CPR/AED Course Registration ($85)

Current Total:

$0.00

Cancellation Policy *

A refund less a $40 processing fee will be provided for cancellations received in writing by September 28, 2023. Send cancellation to inpma@indianapodiatric.org. In lieu of a refund, your paid registration fee can also be applied to a substitute attendee. No refunds will be provided after September 28. We regret that we cannot offer a mixed registration of virtual and in person.