Your Registration

Online Registration is only for new customers; if you are an existing member please send an email to info@empiremedicaltraining.com with your request for registrations. If you have any questions please call 866.366.1576.


Mesotherapy Training -	$0.00
Jan 10 2020 Las Vegas, NV Flamingo Las Vegas

Physician Medical Weight Loss Training -	$0.00
Aug 30 2020 New York City, NY The Westin New York at Times Square

Botulinum Toxin Training -	$0.00
Jul 25 2020 Boston, MA Hotel to be announced

Complete Dermal Filler Training -	$0.00
Apr 26 2020 Charlotte, NC Hotel to be announced

Complete Dermal Filler Training -	$699.00
Jun 28 2020 Empire-Virtual-Training LiveStream / Online Training

PDO Thread Lift Training I & II -	$0.00
Jul 31 2021 Las Vegas, NV The Westin Las Vegas Hotel & Spa

Sclerotherapy for Physicians & Nurses -	$699.00
Oct 09 2020 Empire-Virtual-Training LiveStream / Online Training

Complete Dermal Filler Training -	$0.00
Sep 05 2020 Dallas, TX Le Meridien Dallas by the Galleria

Complete Dermal Filler Training -	$0.00
Sep 12 2020 Orlando, FL Sheraton Orlando Lake Buena Vista Resort

Complete Dermal Filler Training -	$0.00
Oct 03 2020 Las Vegas, NV The Westin Las Vegas Hotel & Spa

Complete Dermal Filler Training -	$0.00
Jun 05 2021 New York City, NY New York Marriott at the Brooklyn Bridge

Cosmetic Laser Courses and Certification -	$0.00
Jul 22 2022 Empire-Virtual-Training LiveStream / Online Training

Complete Dermal Filler Training -	$0.00
Oct 15 2022 New York City, NY New York Marriott Downtown

Botulinum Toxin Training -	$0.00
Jun 11 2022 Denver, CO Grand Hyatt Denver

Botulinum Toxin Training -	$0.00
Jan 21 2023 Empire-Virtual-Training LiveStream / Online Training

Complete Dermal Filler Training -	$0.00
Apr 22 2023 Seattle, WA Renaissance Seattle Hotel

PRP Training for Aesthetics -	$0.00
Apr 23 2023 Seattle, WA Renaissance Seattle Hotel

Allergy Test and Treatment -	$0.00
Jul 14 2023 Empire-Virtual-Training LiveStream / Online Training

Complete Dermal Filler Training -	$0.00
Aug 24 2024 Brooklyn, NY Hotel Indigo Williamsburg - Brooklyn

Complete Dermal Filler Training -	$0.00
Sep 22 2024 Long Island, NY Long Island Marriott

Medical Hair Loss Therapy Training -	$0.00
Dec 20 2024 Empire-Virtual-Training ---

Sub-Total: $1,398.00
(-) Discount: $200.00
remove all discount / vendor code Total Amount Due: $1,198.00

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

CONSUMER AUTHORIZATION FOR DIRECT DEPOSIT VIA ACH

I (we) hereby authorize EMPIRE MEDICAL TRAINING, INC to electronically debit my account as follows at the depository financial institution named below. I (we) agree that ACH transactions that I (we) authorize comply with all applicable law.

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 EMPIRE MEDICAL TRAINING, INC. in writing at the following:

Empire Medical Training, 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
(2.5% Covenience fee)

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 Empire Medical Training terms of service, privacy policy, and cookie policy.