Clone of CA Org: Quote or Invoice:

License either or both of the courses subsidized by the California Health Care Foundation

In filling out this form, you acknowledge that you are fully aware that these courses on their own do not fully meet California training requirements for personnel providing care to perinatal patients.
Name*

First NameLast Name
What is your job title / role at your organization.*
Your email. You must use the email connected to the organization you are representing.*
example@example.com
Your Organization*
Your Department, Division, Unit, or Clinic (or Other Subunit)*
If none, write N/A
Your Organization's Website
You have the option of providing courses on your organization's Learning Management System or on the Humanitas Institute Learning Management System. Where would you like your learners to complete courses?*

On my Organization's Learning Management System (LMS)On the Humanitas Institute Website/LMS (includes access on mobile app)Unsure or Undecided
How can we help with your decision on where to provide courses?
You indicated you ONLY want the original courses. License fees for these courses are covered by CHCF through 2028. We charge a small service fee to cover our administrative and services costs.*

Original Dignity in Pregnancy & Childbirth. DOES NOT FULLY MEET REQUIREMENTS No license fees through 2028.Refresher. Dignity in Pregnancy & Childbirth (Meets CA SB 464 requirement of a refresher every two years. No license fees through 2028.*
Subtotal: S&A Fee for Course Bundle Transfer ($5000).
Read-only. Automatically populated.
What level of service would you like?*

Standard: We provide you with a unique code that you provide to your learners. Learners self-register on our LMS and self enroll, using the unique code provided. You handle all learner communications. Does not include learner monitoring or completion reports. Includes help desk support. You may order reporting separately. ($500.00)Enhanced: We upload, register, and enroll your learners. We then send email invitations with information and instructions to yourur learners. Includes quarterly completion reports. Includes help desk support. ($3,000).Unsure or Undecided
Subtotal: Annual Service Fee
Optional Add-Ons
Would you like to receive monthly learner completion reports? The fee is an additional $1.00 per learner, (Note: You already have quarterly reports included in your enhanced service level).*

NoYes, I would like to move to monthly reports (Adds $3,000)Unsure
Subtotal: Enhanced Service Upgrade to Monthly Reporting (Add-on)
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Would you like to receive learner course completion reports?*

NoYes, annually (Adds $500.00)Yes, quarterly (received on 15th day after quarter end) (Adds $1,500)Yes, monthly (received on 15th day after month end) (Adds $3,000)Unsure
Subtotal: Standard Service Completion Reports (Add-On)
Read-only. Automatically populated.
Would you like to pre-pay for CE exams for all or some of your learners?*

YesNoUnsure
Please write in the number of CE exams that you wish to purchase (pre-pay for). Your fee will be $5.00 per exam.*
Subtotal: Fee for Optional CE Exams
Read-only. Automatically populated.
Your Total Cost
Total Cost
Read Only. Automatically Populated.
Which describes your current needs?

Please send me a quote.We are ready to move forward. Send us an invoice and service specification.Neither - I have a question and will put it in the open text box below
Do you have any questions? Is there anything you would like us to know?
Whats the best way to reach you? Please provide the specific email address or phone number you would like us to use.
Thank you!
Would you also like quotes and invoices sent to someone else?*

No, just meYes
Additional Email Address for Quotes and Invoices*
example@example.com
Billing Address: Street

Street Address

Street Address Line 2

City

Zip Code
Billing Address: City, State, and Zip Code*

Street Address

Street Address Line 2

CityState

Zip Code
2. Original Dignity in Pregnancy & Childbirth. Partially meets SB 464, does NOT meet CA AB 2319. No license fees through 2028.
4. Refresher. Dignity in Pregnancy & Childbirth (Meets CA SB 464 requirement of a refresher every two years. No license fees through 2028.*
3. AB 2319 Supplement: Gender Inclusive Care and Intersectionality (WITH Original Free Dignity in Pregnancy & Childbirth meets CA AB 2319)
1. NEW IN 2026: Updated Dignity in Pregnancy & Childbirth Course (Meets SB 464 & AB 2319). Is equivalent to 2 and 3 (next 2 courses in list) combined.
5. Trangender Inclusive Care (meets the Requirements of CA SB 923, The Transgender Inclusive Care Act)
6. Implicit Bias for New Nurses (Meets the Requirements of CA AB 1407, Implicit Bias Training for New Nurses)
Should be Empty:

License either or both of the courses subsidized by the California Health Care Foundation

Optional Add-Ons

Your Total Cost