Medical Acupuncture for Physicians
AC65 Application

Bolger Center, Potomac, MD
Introductory Weekend: 21-25 March 2019
Clinical One: 21-25 June 2019
Clinical Two: 18-22 September 2019

In addition to completing this form, the following documents are required for your application to be considered. You must submit them via email to mafp@hmieducation.com:

  • Résumé / CV
  • Photocopy or scan of your current medical license
  • Statement of plans (Military applicants: In your statement, please confirm your base command’s endorsement of your training and an acupuncture-friendly clinical setting.)
  • Tuition payment (unless the tuition is funded through a 3rd party)

The fields indicated with an asterisk (*) are required.

Name And Professional Information


FemaleMale



Contact Information

Home Address:



Military Personnel & Government Employee Applicants Only


Pathway*

Pain ManagementPrimary Care

Tuition*

300-Hour CME course: $11,000 by credit card, $10,750 by check($11,500 after 19 February 2019) Full-time Resident or Fellow: $9,000 by credit card, $8,750 by check($9,500 after 19 February 2019)

Indicate method of payment:*

CheckPreferred - Payable to Helms Medical Institute, 2520 Milvia Street, Berkeley, CA 94704 Credit Card - onlinePay online at https://mkt.com/hmiCredit Card - by phoneCall 510-649-8488 between 9am and 2pm Pacific Time or fax to 510-649-86923rd Party Payment

Supplemental Materials

The following documents are required to process your application:

  • Résumé / CV
  • Photocopy or scan of your current medical license
  • Statement of plans (Military applicants: In your statement, please confirm your base command's endorsement of your training and an acupuncture-friendly clinical setting.)
  • Tuition payment (unless the tuition is funded through a 3rd party)

Your personal check will not be deposited until you have been accepted to the course.

Once you have submitted this online application you will receive a confirmation email. Please email MAFP@HMIeducation.com with the above documents as attachments. Be sure to add hmieducation.com to your approved sender list.

All training activities will take place at the Bolger Center, Potomac, MD. You are requested to lodge at the hotel where a group rate has been arranged. A conference day use fee of $80 per day is required of participants who choose to stay elsewhere or room with another course participant.

For additional information about this course, call 510-649-8488 or e-mail mafp@hmieducation.com.