AO North America


Pre-Course Questionnaire


This must be completed for registration form to be processed.


HOW MANY YEARS IN PRACTICE?:


or

PGY:


HOSPITAL/UNIVERSITY AFFILIATION:


PRIVATE PRACTICE:


OTHER:


HAVE YOU ATTENDED A PREVIOUS DISTRACTION COURSE?:


ARE YOU CURRENTLY USING DISTRACTION OSTEOGENESIS?:
YES
NO

IF YES, FOR WHAT PROCEDURES?:

SPECIALTY TRAINING?:

WHAT DO YOU EXPECT TO LEARN THAT WOULD BENEFIT YOU IN YOUR PRACTICE?
PLEASE EXPLAIN IN AS MUCH DETAIL AS POSSIBLE:


Press this button to submit your request:

Thank you for your interest!