Seminar Registration Form

Seminar Information

"The Smile Solution: A Practicum" This is an intensive hands-on course with live patient treatment that focuses on you and your patient. The program is held at local dental offices and is limited to 5 doctors. Each doctor provides a patient and one or two chair side assistants. Purpose: To provide General Dentists with practical knowledge of the materials, procedures and systems required to confidently achieve consistent success with multiple unit anterior cases. Schedule: Each course consists of three days over two weekends. The first weekend is on a Friday and Saturday, with Clinical Lectures and Case Studies on Friday and Patient Prep on Saturday. The third day is 3 or 4 weeks later, with 2 hours of lecture followed by case cementation. Learning Objectives: Understanding of Scientific and Esthetic Principles of Smile Design. Preserving Esthetic Results with Functional Occlusion. Use of Simplified and Predictable Clinical Techniques for Esthetics. Material and Instruments Required for Proven Results. Use of Digital Photography for Improved Clinical Communications. Case Selection Principles and Case Presentation Options. Wax-Up vs. Mock-Up: Combining the best of both. Instructors: Instructors are drawn from the faculties of several post-graduate esthetic programs. All of them have extensive teaching and mentoring experience with doctors who want to expand their esthetic skills and knowledge . Costs: Course fee for Doctor and one assistant: $2295 Additional assistant: $125. Lab Fees for the course are additional and are estimated at $2000 for an 8-10 unit case with models and diagnostic wax-ups.

Credits:	24 CE credits	Dr @ $2295
		Team Member @ $125
Location:		TOTAL	$
		If emailing this form, your total will be calculated automatically.

THE FOLLOWING REQUIRED FIELDS ARE MARKED WITH AN ASTERISK *.

*Doctor:
*Address:
*City:
*State:		*Zip:
*Phone:		Fax:
*E-mail:

Names of team members attending: