D2: Level 2 Botox & Dermal Filler Dental Training
16 CE (ADA CERP & AGD PACE Recognized)
Please enter your full name and degree as you would like to appear on your completion certificate. Example: John A. Smith, DDS
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Trinidad and Tobago
Bosnia and Herzegovina
United Arab Emirates
Papua New Guinea
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Sao Tome and Principe
United Republic of Tanzania
Country / Region
State License #
Please select the 16 CE course you wish to attend:
December 7-8, 2019 - Portland, OR
January 18-19, 2020 - Miami, FL
July 25-26, 2020 - Miami, FL
Enter Promotion Code for Tuition Discount
(Discount will not appear online now, however it will be applied when processed. Note: Only one discount per registration)
Included with $3650 Course Tuition:
- Up to $400 in Botox units for the Day 2 Hands-on clinical
- Complete Advanced Lecture Presentation Materials
- Breakfast & Lunch Included Both days
- Before/After pictures of your model patient
- Certificate of course completion - 16 CE (ADA CERP & AGD PACE Recognized)
Would you like to bring a staff member to attend the program with you?
Both Days - $425
Saturday Lecture Only - $250
Not Bringing Staff
Staff Member Name (if bringing)
Sunday will be the full day hands-on clinical and the only day you will need a patient(s).
ALL patients must be approved in order to ensure they are qualified candidates for advanced treatments. Choose to either bring a model patient, or we can provide a volunteer model at no additional charge. If you would like us to provide a qualified model, please let us know ASAP or no later than 2 weeks prior to course date.
If you are planning to bring a model patient, please e-mail a non-smiling picture of your patient to email@example.com
Second-Day Hands-On Clinical
I will bring a model patient with me and will submit a picture for prior approval
Please provide a volunteer model patient (no additional charge)
Patient Name (if bringing)
Additional Costs and Product Needs:
Because we are doing more extreme makeovers on patients, participants will be doing several Botox and dermal filler treatments that require more product. For this reason, we give participants the option to work with a partner so they can do all the procedures but share costs of product with a partner participant
DentaSpa will provide the Botox units for clinical (up to $400 included). Students may choose to buy additional units for practice at cost ($6.01 per unit). However, this is optional because the Botox units included with registration are sufficient to cover all the areas we are doing during the clinical.
Depending on whether you partner or not, you will need to purchase Juvederm and Radiesse dermal filler product to do the clinical treatments. Radiesse, as discussed in the Comprehensive course, is a longer lasting material that builds volume at deeper dermal plane.
Keep in mind if you work with partner, your cost for materials will be less and you will still be doing all the procedures.
An Evaluation will be sent prior to the course. There are varying factors that will determine the amount of dermal filler product needed, including: Partnering, bringing your own patient, and the treatments you are comfortable with.
Would you like to partner with another doctor or work on your own?
I would like to partner with another doctor and share the cost of materials
I would prefer to work alone
Any Additional Information? (food allergies, special accommodations, name of your patient(s), etc.)
Billing Information - When you click submit, you will be taken to our online payment portal.
Please note that in order to accommodate your attendance, payment for the course must be made in full at least 1 month prior to the course date.
****Unless otherwise instructed here, any balance will be processed 1 month prior to the course date****
Special Instructions for billing, if any:
Terms and Conditions
Please read completely
I understand that, once registered, I am reserving one of a limited number of spaces in a DentaSpa training course and that my reservation may prevent another practitioner from participating in the course. As such, I understand that to avoid a $299 Rescheduling Fee, I am responsible for determining my availablity in advance and will advise DentaSpa within four (4) calendar weeks of the course date if I am unable to attend and need to reschedule. As class sizes are limited and DentaSpa incurs logistics costs for each registrant, I understand that DentaSpa offers rescheduling, however no refunds. My signature also guarantees that I will take it upon myself to ensure that the procedures being taught are legally permitted in my state of licensure under my Board's current laws and legislation.
I understand that I have the option to print this form, sign, and fax to (305) 938-5018. By submitting online, I am authorizing DentaSpa Seminars to process my registration for the selected course(s).
By checking this box, I am signifying that I have read and understand these terms and conditions.
Please type in your full name to act as your signature in full agreement with these terms and conditions.