2024 DSHP Event Registration
DSHP programs and events are FREE for DSHP members.  We thank you for your continued membership and support!  Non-members will be charged the $45 non-member fee towards the development of future DSHP programs.  

- Registration: 6:00 PM
- Presentation and dinner: 6:30-7:30 PM

Please note that your registration is not confirmed until you receive an email from the DSHP Education Committee. 

We look forward to seeing you at the event!

Sincerely,
The DSHP Education Committee
(dshp.events@gmail.com)

CSHP Event Code of Conduct: https://cdn.ymaws.com/www.cshp.org/resource/resmgr/files/about_cshp/CSHP_Code_of_Conduct.pdf

Email *
DSHP Member status *
Date of the program. 
Registration closes two business days before the event.  Duplicate registrations will be disregarded.
 *
MM
/
DD
/
YYYY
Email address. Please use a different email address for each person registered. *
First name *
Last name *
Title *
NPI. You may search for your NPI:  https://npiregistry.cms.hhs.gov/  *
License. Please indicate type and number (example: "RPH 12345", "CPT 12345", "INT 12345"). *
Workplace *
Workplace address *
Your registration is not confirmed until you receive an email from the DSHP Education Committee.  *
If your plans change and you are unable to attend, then we kindly ask that you notify us within 2 business days of the event. Late cancellations or "no shows" may result in lower priority registration for future events. *
Special meal request
Clear selection
A copy of your responses will be emailed to .
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms