Register seminar attendees

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This registration page is for Professional Pilots only. Registration under this category does not include Educational Credits.
Professional Pilot’s registration fee is $275.00

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

First Name*:
Last Name*:
First Name as you would like it to appear on your badge*:
Rank*:
Airline*:
Professional Category*:
Title*:
Email*:
Address*:
Extended Address:
City*:
State*:
Country*:
Zip*:
Phone*:

First time HIMS Attendee?*
Yes
No

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: Charles.chesanow@faa.gov 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: Chris.Front@faa.gov 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?*
Yes
No

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
Neuropsychologists
Psychiatrists
AME's
Counselors, EAP, Other Mental Health Professionals
I will not be attending a breakout session

Will you be attending breakfast on Wednesday September 27th?*
Yes
No


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

This is an example of how your seminar badge will be printed. If everything looks correct press continue below. If you need to edit your badge, select Edit and scroll to the top of the registration page and make your corrections. Select Continue to view your badge again.