Step One: Create Your Account

Select your username and password

All fields are required

Username

E-mail Address

Confirm E-mail Address

Password

Confirm Password

Tell us about yourself

All fields are required

Full Name

Phone Number

Street Address

Street Address (Additional)

City

State

Zip Code

Country

Are you a ______ ? (Choose your member type)

Member type is required

Dentist

Medical doctor with a dental practice

Dental Team Member

Medical professional such as a hygienist or staff member working in a dental practice

Dental Patient

Patient looking for a comfort dentist and dental information

Dental Vendor

Merchants providing comfort dental medical equipment

E-mail Notifications

By accepting to receive daily email news notifications you will be kept informed of news associated with Dental Comfort Academy.

CAPTCHA

CAPTCHA is required

array (
  'form_build_id' => NULL,
  'form_id' => NULL,
  'form_token' => NULL,
  'account' => 
  array (
    'name' => 
    array (
      '#description' => '',
      '#title' => '',
      '#printed' => true,
    ),
    'mail' => 
    array (
      '#description' => '',
      '#title' => '',
      '#printed' => true,
    ),
    'conf_mail' => 
    array (
      '#description' => '',
      '#title' => '',
      '#printed' => true,
    ),
    'pass' => 
    array (
      'pass1' => 
      array (
        '#description' => '',
        '#title' => '',
        '#printed' => true,
      ),
      'pass2' => 
      array (
        '#description' => '',
        '#title' => '',
        '#printed' => true,
      ),
    ),
  ),
  'Personal Information' => 
  array (
    'profile_full_name' => 
    array (
      '#description' => '',
      '#title' => '',
      '#printed' => true,
    ),
  ),
  'locations' => 
  array (
    0 => 
    array (
      'phone' => 
      array (
        '#description' => '',
        '#title' => '',
        '#printed' => true,
      ),
      'street' => 
      array (
        '#description' => '',
        '#title' => '',
        '#printed' => true,
      ),
      'additional' => 
      array (
        '#description' => '',
        '#title' => '',
        '#printed' => true,
      ),
      'city' => 
      array (
        '#description' => '',
        '#title' => '',
        '#printed' => true,
      ),
      'province' => 
      array (
        '#description' => '',
        '#title' => '',
        '#printed' => true,
      ),
      'postal_code' => 
      array (
        '#description' => '',
        '#title' => '',
        '#printed' => true,
      ),
      'country' => 
      array (
        '#description' => '',
        '#title' => '',
        '#printed' => true,
      ),
    ),
  ),
  'simplenews' => 
  array (
    'simplenews-1' => 
    array (
      '#title' => 'Receive DAILY e-mail notifications of news posted to this site.',
      '#description' => NULL,
      '#printed' => true,
    ),
  ),
  'captcha' => NULL,
  'submit' => 
  array (
    '#value' => 'Next',
    '#title' => NULL,
    '#description' => NULL,
    '#printed' => true,
  ),
)

This is test 1 of DOT

[graphviz] digraph G {"舊金山和氣" -> "列治文互愛"} [/graphviz]

 

 

四弘誓願