Training Course Signup
Participant Registration Form
Referred Agency Name if none N/A in subject line
Participant
First Name
Last Name
Course of Interest
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example@example.com
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Course List
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Coding
per person this includes CPR
$
2,000.00
Billing
per person this includes CPR
$
1,800.00
Billing, Coding, and Administration
per person this includes CPR
$
4,500.00
Quantity
1
Medical Office Assistant
per person teaches medical terminology and insurance, record-keeping scheduling, and CPR CNA 1
$
1,900.00
Quantity
1
2
3
4
5
6
7
8
9
10
Administration $1500.00
per person teaches you overseeing the front office, greeting guess taking calls, making calls, posting payments AR paying vendors and CPR, CNA 1
$
1,500.00
Quantity
1
2
3
4
5
6
7
8
9
10
RegistrationCoding • Registration for the coding exam
per person refundable if the participant declines the exam. (only 20 participants will be eligible at a time to take this course)
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
Registration Billing • Registration for the billing exam
per person refundable if the participant declines the exam. (40 participants will be eligible to take this course)
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
Registration for the Medical Office and Assistant Administration Office Support exam
per person (only 5 participants from both programs will be eligible at a time to take this course)
$
125.00
Quantity
1
2
3
4
5
6
7
8
9
10
Exams Coding
per person, this includes a membership for 1 year with AMBA
$
300.00
Quantity
1
2
3
4
5
6
7
8
9
10
Exams Billing
per person, this includes a membership for 1 year with AMBA
$
175.00
Quantity
1
Exams Administration and Medical Office
per person, this includes a membership for 1 year with AMBA
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
CSP registration/Orientation and Intake
per person full 4 hours going over the program, paper onboarding, Bio background, and training courses.
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Debit or Credit Card
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