Coding Registration
  1. You can fill out this SECURE Online form or you can download, print, and mail a form with your check or credit card information to:

    Connecticut Orthopaedic Society
    Susan Schaffman - Executive Director
    26 Riggs Avenue
    West Hartford, CT 06107
    P: (860) 690-1146
    F: (860) 955-1178
  2. Are You a COS Member?(*)

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  3. First Name:(*)
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  4. Last Name(*)
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  5. Address:(*)
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  6. City, State Zip:(*)
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  7. Phone:(*)
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  8. Email Address:(*)
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  9. Fax (optional)
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  10. Members will be billed $295.00
    Non-Members will be billed $425.00
  11. Please Enter the Numbers(*)
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