Ophthalmology Connection Registration - Platinum

PLATINUM TIER MEMBERSHIP
51-150 Learners
$725 annual membership + $33 per learner

You are one step closer to membership on the leading online practice management and training resource for eyecare clinics.

Please submit the following information to register for BSM Connection for Ophthalmology.
Your learner count and payment information will be requested on the following page.

Practice Information

Practice Name *

Mailing Address *

City *

State *

Postal Code *

Phone Number *

Fax Number

Member Information

First Name *

Last Name *

Email *

Position/Job Title *

Are you affiliated with an ASC? *

Yes

No

Are you a Member of ASOA? *

Yes

No

How did you hear about us? *

Questions? Contact Customer Support

PLATINUM TIER MEMBERSHIP 51-150 Learners $725 annual membership + $33 per learner

PLATINUM TIER MEMBERSHIP
51-150 Learners
$725 annual membership + $33 per learner