Register seminar attendees

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This registration page is for Health Professionals or other Non-Pilots. Registration under this category includes Educational Credits.
Health Professionals or other Non-Pilot’s registration fee is $425.00

Please Note: We will use the first 7-9 fields for your Name Badge
* denotes required fields.

First Name*:
Last Name*:
First Name as you would like it to appear on your badge*:
Credential 1 (MD, PhD, ABPP, etc.) Please use one per line.:
Credential 2:
Credential 3:
Company or Airline*:
Professional Category*:
Specify Category*:
Extended Address:

First time HIMS Attendee?*

First time attendee approval pass code required for AME, Psychologist and Psychiatrist only; no other Professional Category requires a pass code: (Correct code must be input)*:

First time AME’s require a pass code to register for the HIMS Basic Seminar. Please contact your Regional Flight Surgeon for approval and the pass code.

First time Psychiatrists require a pass code to register for the HIMS Basic Seminar. Please contact Dr. Chesanow for approval and the pass code: 202-267-3767

First time Psychologists require a pass code to register for the HIMS Basic Seminar. Please contact Dr. Front for approval and the pass code: 202-267-5525

Seminar Manual? *
I want a hard copy of the Seminar Manual when I check-in
I do not need a hard copy of the manual, I will download the manual from the website

Which days of the seminar will you attend?*
Note: Full registration fee is required regardless of days attended.
Monday, September 25th
Tuesday, September 26th
Wednesday, September 27th

Will you be at Birds of a Feather meeting (Public Welcome!) on the evening of Monday, September 25th?*

Breakout sessions are at 10:30 am Tuesday, September 26th. Which breakout session will you attend?*
Peer Monitors and Union HIMS Chairs
Management HIMS Team
Counselors, EAP, Other Mental Health Professionals
I will not be attending a breakout session

Will you be attending breakfast on Wednesday September 27th?*

For any issues regarding registration please email or call 303-341-5220 and ask for HIMS Registration Support.

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