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To confirm your participation and register for the iHT2 Health IT Summit in New York City taking place September 19-20, 2012 please complete the online registration form below. Once we have processed your registration you will receive an email confirming your attendance. Please note that none of your information will be shared with any 3rd parties. Please also note that your complimentary pass does not include lunches for both days of the Summit. To purchase the lunches ($59) and ticket to the networking cocktail reception please click on the lunch link in your confirmation email you receive upon completing this registration.
***As a result of the limited supply and high demand for this program, iHT2 will be taking all registrants credit card information in the secure form. The card WILL NOT BE CHARGED; however, any registrant that cannot make the Summit must contact Matthew Raynor at 561-748-6281 by COB on September 17th or your credit card will be charged the conference pass fee of $195. Any questions please do not hesitate to call. |
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| Are you a provider, payer, physician, government employee, or education employee? |
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| How did you learn about the Health IT Summit in New York City? |
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| Did you receive this invitation from a Technology Provider as a referral? |
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| If Yes, please provide the Technology Provider's name | | |
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| Do you feel you are maximizing the use of your healthcare IT budget and receiving the appropriate ROI? |
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| How would you best describe your organization? |
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| Which topics as they relate to IT, do you feel are a focus for your organization? |
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| Do you currently have integrated solutions that enable you to effectively support and manage healthcare business and IT requirements? |
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| Do you purchase through a solution provider (VAR)? |
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| Do you plan to implement additional healthcare IT solutions within your organization in the next 12-24 months that supports your initiatives? |
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| What is your organization’s annual IT budget? |
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| What level of involvement do you have in the decision making process when it comes to IT purchases? |
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| How many people are employed in your entire organization? |
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| What is the total number of licensed beds which your facility staffs? |
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| How many insured lives does your organization service? |
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| What is your organization’s total annual revenue? |
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| What topics are you interested in learning about? (Select all that apply) |
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| What are your goals and objectives for attending this program? (Select all that apply)? |
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| Please help us in better matching you with your peers and vendors by answering what solutions you have interest in investing in within the next 12-18 month period:
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| Do you currently have an EMR? |
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| If yes, please specify what software (and if you have more than one please specify) | | |
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| Has your organization attested for Stage 1 Meaningful Use? |
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| First Name | | | | Last Name | | | | Job Title | | | | Company | | | | Address | | | | City | | | | State | | | | Zip | | | | Phone | | | | Email Address | | | | Association Membership Number | | |
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| Please enter your credit card information below. Your card will not be charged provided you check-in on the first day of the Summit or follow the cancellation policy by canceling on or before September 17th. If you prefer to give your credit card information over the phone please contact Matthew Raynor at 561-748-6281. *This is a secure form. |
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| Credit Card Type | | | | Credit Card Number (please no dashes) | | | | Security Code (located on the back) | | | | Credit Card Expiration Date | | |
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| As an iHT2 registrant you’re entitled to a free subscription to Health IT SmartBrief: a concise, comprehensive e-mail news briefing of the day’s top healthcare IT stories, delivered three times per week |
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| Please process my registration for the iHT2 Health IT Summit in New York City. I agree by clicking below that I am confirming my attendance. |
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