1. Contact Information (required)

First Name *

Last Name *

Phone *

Email *

Practice Name *

2. Eligibility Confirmation (required checkboxes) *

I am an existing Dentium implant client of Elexadent.

I am able and willing to travel to Monaco at my own expense for the EAO and the course from 18 - 20 September 2025.

I understand that travel, accommodation, meals, and other costs are not included.