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Upgrade Virtual Diamond to Platinum	$2,000.00 Spring Discount Applied remove
1 Year Term ---

VOD - Dermatology Procedures for the Primary Care Practice	$699.00 Spring Discount Applied remove
Jan 01 2040 On Demand Course On Demand Course

Platinum Membership - 3 Payment Plan	$2,187.00 Spring Discount Applied remove
1 Year Term 1 Yr Membership

Fast Track: Intensive Dermal Filler Training	$3,799.00 Spring Discount Applied remove
Oct 26 2025 Chattanooga, TN Empire Chattanoga, TN Center of Excellence

Clear Cart discount / vendor code codes cannot be combined. Use only one per order. Registration: $8,685.00 Credit Card Convenience Fee: $260.55 Total Amount Due: $8,945.55

1 - Customer Information

First Name:

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Are you a Practice Owner?:

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Name of Account Rep who guided you, if any:

Would you bring your own model?: (if applicable)

Would you like to participate as a model for others?: (if applicable)

2 - Payment Information

eCheck Payment

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Amount to be Charged:

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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):

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eSignature: (Please type your full name)

Credit Card Payment
(3.0% Convenience fee ($260.55))

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3 - Billing Information

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I acknowledge that I have read and agree with the Empire Medical Training terms of service, privacy policy, and cookie policy. California courses attendees: In order to inject during hands-on sessions, you need to be licensed to inject in California.

Amount to be charged: $8,945.55