KETO - Family Registration | CITE

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Ketogenic Diet Therapy Events - Family Registration (June 10th)

Click if you are interested in attending the Patient and Family Night (June 10th, In-Person Only)

First Name

Last Name

Professional Designation (if appliable)

Institution (if applicable)

Email

Name and Credentials on Badge

Dietary Restrictions

Will anyone else be joining your group?

First Name

Last Name

Email

Name and Credentials on Badge

Dietary Restrictions

Will anyone else be joining your group?

First Name

Last Name

Email

Name and Credentials on Badge

Dietary Restrictions

Will anyone else be joining your group?

First Name

Last Name

Email

Name and Credentials on Badge

Dietary Restrictions

Thanks for submitting!

Canadian Institute for the Transfer of Knowledge (CITE)

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Tel: 905-525-8213 | Fax: 866-714-5521

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