Acumed Medical Education Sign-In Medical Education Sign-In Event Date * First Name * Last Name * Email * Zip Code * Education Level or Role * ResidentFellowPracticing SurgeonSalesOther Education Level or Role NPI Number * I understand that my personal information will be processed in accordance with Acumed's privacy policy. I further understand and agree that during the event, I may be photographed, recorded and/or videotaped by Acumed for internal, educational and/or promotional use. I represent that I am 18 years or older and voluntarily authorize Acumed and those acting on its behalf the right to photograph, record and/or videotape the Activity (“Content”) and to use, alter, copy, copyright, modify, publish, reproduce, and/or transmit such Content in any medium or format, including, without limitation, through websites and/or on social media channels. Submit If you are human, leave this field blank.