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MOCA WAITLIST REGISTRATION

Please fill out the information below to be placed on the waitlist for this course. We will take people off the waitlist on a first-come, first-serve basis. By placing yourself on the waitlist, you will not be charged but, as these courses fill quickly, we strongly recommend that you sign up for one of the available courses so that you guarantee your place in some course. You will only be charged once. If you get picked from the waitlist, we will automatically transfer you to that course and notify you accordingly.

Course Date:
Course Title: MOCA Simulation Course
Last Name:   *
First Name:   *
Specialty:
   
Address 1:    *
Address 2:
City:   *
State:     *
Zip Code:    *
Home Phone:    *
Mobile Phone:  
   
E-Mail Address:    *
(Must be valid to receive confirmation notice)
   
ABA Board Certified?    
How did you hear about this course?
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Select the 3rd letter from the left of the word [Rosemaria].
 

 

 

 

If you have any questions, please contact Jonathan Garza, Coordinator, Patient Simulation Center at (409) 747-8790.

 

 

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Anesthesia Center Staff

Director
Ronald Levy, MD

Assistant Director
Stefanie Fischer, MD

Education Director
Beth Teegarden, MD

Business Operations
Isela Ramos, MBA

Teaching Faculty
Axel Rodriguez, MD
Ryan Griffin, MD
Michael Cook, MD


Support Staff
Lyndsey Phillips