Thank you for being a part of Heart Failure University as an esteemed faculty member. We look forward to a hearty program that includes didactic lectures, case-based discussions, and faculty panels. Your participation is key to reaching our goal of developing tomorrow’s physician leaders in this important field.

Please complete the information below so that we can begin your registration, travel and lodging reservations.

Faculty Registration

Contact Information

Please provide information exactly as it should appear in printed documents

Honorarium & Compliance Information

Emergency Contact

Travel Options

Once you submit your registration, you will be contacted by our travel agent, McVeigh Associates, with a tentative itinerary for approval.

Air Travel Information

as printed on your government ID

Hotel Information

Additional Information

Note: You will also need to complete a W9 form. We will send a blank form to you via email.

If you have any questions, please contact Steven Black at