Documentation, Coding, and Billing Specialist Certification (Urology)

Registration Form
Documentation, Coding, and Billing Specialist Certification (Urology)
For Coders, Billers, and Admins
Registration/Payment Details

My Registration*

$1,097.00 Select Number of Registrants**
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**Upon completing the payment of your registration fee, you will be directed to a form to provide the necessary registrant information.
Practice Name
Registrant's Name

First NameLast Name
Registrant's Email*

Confirmation Emailexample@example.com
Registrant's Mailing Address (for Pocket Card and Wall Chart)*

Street Address 1

Street Address 2

CityState / Province

Postal / Zip Code
I understand this is an annual subscription that AUTO renews each year and my credit card will be charged the renewal rate of $636 each year unless I cancel my subscription at least 30 days prior to the renewal date.
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Registration Form