Your Registration

Online Registration is only for new attendees; 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.


Complete Dermal Filler Training	$999.00 remove
Apr 26 2020 New York City, NY The Westin New York at Times Square

Mesotherapy Training	$999.00 remove
May 29 2020 New York City, NY The Westin New York at Times Square

Complete Dermal Filler Training	$1,399.00 remove
Aug 02 2020 Las Vegas, NV Bally's Las Vegas Hotel and Casino

Submental Liposuction	$1,199.00 remove
Dec 14 2020 Las Vegas, NV The Westin Las Vegas Hotel & Spa

Joint / Extremity / Non-Spinal Injection Course	$999.00 remove
Jun 13 2020 Empire-Virtual-Training LiveStream / Online Training

Anti-Aging (Modules I & II)	$1,199.00 remove
May 01 2021 New York City, NY The New Yorker A Wyndham Hotel

Joint / Extremity / Non-Spinal Injection Course	$699.00 remove
Oct 17 2020 Empire-Virtual-Training LiveStream / Online Training

Complete Dermal Filler Training	$1,299.00 remove
Oct 24 2020 Seattle, WA Archer Hotel - Redmond Town Center

Advanced Botox and Dermal Fillers (Level II)	$1,299.00 remove
Aug 22 2021 Cincinnati, OH Cincinnati Marriott at RiverCenter

Complete Dermal Filler Training	$1,399.00 remove
Nov 13 2021 Chicago, IL Sheraton Grand Chicago

Body Contouring Injectables & Adjunct Procedures	$699.00 remove
Aug 29 2021 Empire-Virtual-Training LiveStream / Online Training

Botulinum Toxin Training	$1,399.00 remove
Sep 17 2022 Los Angeles, CA Sheraton Park Hotel at the Anaheim Resort

Hormone Pellet Training and Therapies	$1,399.00 remove
Jul 22 2023 Orlando, FL Signia by Hilton Orlando Bonnet Creek

PDO Thread Lift Training I & II	$2,499.00 remove
Nov 05 2023 Chicago, IL Sheraton Grand Chicago

Advanced Botox and Dermal Fillers (Level II)	$2,099.00 remove
Sep 10 2023 New York City, NY New York Marriott at the Brooklyn Bridge

Sub-Total: $19,585.00
(-) Discount: $200.00
remove all discount / vendor code Total Amount Due: $19,385.00

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:

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

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.