Physician Registration

This form is for Physicians and APPs only. Industry representatives should use the Industry Rep Registration form located in the Sponsor/Exhibitor tab.

First Name*

Last Name*

Badge Name*

Email*

Company

Address*

City*

State*

Postal Code*

Phone*

Occupation*

Cardiologist

Cardiovascular Surgeon

Advanced Practice Provider

Professional Designation

Professional Designation (Other)

Specify Department/Specialty

ATTENDEE & EVENT REGISTRATION

Please indicate a quantity from each applicable field below. Your selection(s) will calculate automatically and provide a total below.

Spouse/Guest:

$200 (anyone over 20)

Spouse/Adult Guest(s) Name(s):

Please enter one full name per line

Children's Fee over 4 yrs. old ($50 per child):

Children's Fee under 4 yrs. (no charge):

Children's over 4 yrs. old Names

Please enter one full name per line

Children's under 4 yrs. Names

Please enter one full name per line

GOLF

(Optional) Golf Friday:

$75 per person

Grand Total: $

CANCELLATION / REFUNDS

Cancellation Policy:
On or before June 30: No Cancellation Fee
July 1- on: 50% Cancellation Fee

PAYMENT METHODS

Select Payment Method:*

Credit Card (AX, VI, MC)

Check: Mail to SACS, 10300 Brier Mill Court, Alpharetta, GA 30022

NOTE: Credit card transactions will be assessed a 3% transaction fee.

Card Number:*

Name (as it appears on card):*

Billing Address:*

Billing Zip Code:*

Expiration Month:*

Expiration Year:*

CVV:*

Please only press the submit button ONCE. This process may take a few moments to complete as payment will be processed upon submission of this form. Thanks for your patience!

Updates:
- Know before you go!
  All you need to know about Wild Dune's COVID policies.
- A Tribute to our Colleague and Friend Dr. Francis Robicsek
  Dr. Francis Robicsek, pioneering surgeon, humanitarian, long-term supporter of SACS, and friend and mentor to all, passed away peacefully April…
- About the Chairman
  SACS is excited to have Chairman Vinod Thourani back for 2021, along with Co-Chair Jorge Alegria….
Newsletter Signup
Stay informed on the latest from South Atlantic Cardiovascular Society!

Your Name (required)

Your Email (required)

MISSION:

The mission of the South Atlantic Cardiovascular Society is to promote the advancement of current knowledge and skills in the field of cardiovascular care and to improve cardiovascular patient care.
Connect With Us
Useful Links
Quick Contact

South Atlantic Cardiovascular Society A Non-Profit Organization for Cardiac Professionals
10300 Brier Mill Court
Alpharetta, Georgia, USA 30022
770-751-1461 Barb@bhevents.net

Menu

Accommodation Links

Useful Links

Physician Registration

ATTENDEE & EVENT REGISTRATION

GOLF

Grand Total: $

CANCELLATION / REFUNDS

PAYMENT METHODS

Updates:

Newsletter Signup

MISSION:

Connect With Us

Useful Links

Quick Contact