Physician Registration

List Your Practice Details FREE!

Register today to have your Practice Details Listed FREE in our online directory for readers to search and find their nearest OB/GYN!

Plus, we will automatically sign you up for your free AMWA e-membership, to receive AMWA's weekly NewsFlash via e-mail.

As a thank-you for registering we will also enter your name into our FREE PRIZE DRAW to win a flat-screen TV for your waiting area!

Winner!
Dr. Sieman of Des Moines, IA, was one of the participating physicians who registered with You & Your Family. His practice was chosen randomly from a drawing to win a flat screen TV for his office. To register and have your practice details listed on our referral page, please just complete below and hit Register.**

**All doctors licenses will be verified by CW Publishing Group.

Clinic Name:  
Physician First Name:   *
Physician Last Name:   *
Physician Licence number:   *
Practice Address:   *
City:   *
State:   *
Zip Code:   *
Practice Phone No:   *
Email Address:   *
Website Address:  
Please enter your desired password below to access youandyourfamily.com
Password:   *
Would you like your Practice details listed FREE on youandyourfamily.com’s Physician Directory?   Yes No

CW Publishing Group will promise to take care of your information. We will use the information you give us to send you further information or special promotions. Your details may be passed on to other carefully selected third parties who may also contact you with further free samples or offers which we feel may be of special interest to you and your family. You may be contacted by mail or email.

We do not share your information with third parties except where necessary and where required by law.

Would you like to receive further information or special offers from CW Publishing Group or their partner organizations? Yes No
Are you distributing You & Your Family to your patients?     Yes No
If not, why?  
Approximately how many babies do you deliver per month?  
Approximately how many patient visits do you have per month  
Would you like to receive a complimentary stand to display the books in your office?     Yes No
Would you like to receive an additional box of books?     Yes No
How many boxes (approx. 30 books per box)?  
Is this your office address?     Yes No
If you no longer wish to receive the publication, check here?  

Terms and Conditions:
The prize drawing will be awarded by CW Communications Inc. The prize is 1 x flat-screen TV and $500 of children’s toys/books. All valid entries received by the last day of June 2007 will be registered for entry. Entry to this competition is restricted to registered physicians only. Employees of CW Communications Inc. and its subsidiaries as well as those of participating companies will not be eligible. CW Communications Inc. reserves the right to feature the name and location of the Prize Winner. A list of winners will be available on request if accompanied by a postage paid self-addressed envelope marked You & Your Family Physician Registration Winners. CW Communications Inc. does not accept liability for any entries which are illegible, lost or damaged in transit. No correspondence will be entered into regarding the Drawings.
CW Communications Inc., 10 East 38th Street, 3rd Floor, New York, NY 10016.
CW Communications Inc. agrees to abide by the terms and conditions of the National DNC Registry.

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