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Attendee E-mail Address
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First Name (as it should appear on your name badge)
Last Name (as it should appear on your name badge)
Physical Medicine/ Rehab
Pulmonary/ Sleep Medicine
Urgent Care Medicine
Practice Phone Number
Mobile Phone Number
How long have you used eClinicalWorks?
Less than one year
How many providers are in your practice?
1 - 10
11 - 25
26 - 50
51 - 100
101 - 150
Which role best describes your daily job function?
None of the above
Which eClinicalWorks National Conferences have you attended in the past?
This is my first time attending!
I've been to ALL of them!
2018 - Nashville
2016 - Orlando World Center
2015 - Nashville
2014 - Orlando World Center
2013 - San Antonio
2012 - Washington, D.C.
2011 - Phoenix
2010 - Orlando, Gaylord Palms
2009 - Las Vegas
2008 - Orlando, Omni Hotel
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terms and conditions
I would like to sign up for eClinicalWorks newsletter and event information.
Each year, eClinicalWorks invites customers and industry experts to present at our National Conference. If you are interested in sharing your expertise, let us know by first completing a conference registration and then selecting Yes under the Presenter Information section of the registration form. In doing so, you will be added to a pool of potential speakers. Our conference content committee may reach out to you if your areas of interest and expertise match the needs of the conference. eClinicalWorks cannot guarantee an invitation to present.
Selected presenters are required to complete several steps prior to the Conference. We have provided an overview below. These are only required should you be chosen as a presenter.
Required forms include:
Signed anti-kickback certification form
Signed speaker acknowledgment form
Additional presenter requirements and information:
Complete a presentation dry run with eClinicalWorks before August 18, 2019.
Submit your completed presentation to eClinicalWorks before August 18, 2019.
The deadline for eClinicalWorks to select and notify accepted presenters is August 18, 2019.
Conference registration fees will be reimbursed for selected presenters.
Travel, lodging, and costs are the responsibility of the presenter(s).
All presenters agree that video recording obtained of their presentation during the Conference is owned by eClinicalWorks and can be used for future publication, educational, and marketing purposes.
eClinicalWorks reserves the right to revoke the selection of any presenter for failure to complete any of these above listed requirements. Should the attendee fail to complete their presentation, they will be charged the maximum registration fee of $950.