Registration Form
Are you a healthcare professional looking to enhance yoour career and learn a new a skill? Our phlebotomy workshop is just for you! Come join our phlebotomy workshop and learn the fundamental skills of phlebotomy! During the workshop you'll gain hands on practice with drawing blood, specimen collection and so much more! After successful completion of the workshop, you'll immediately receive a completion certificat and further assistance with registrating for the NPS phlebotomy certification exam. Phlebotomy Workshop May 16-17, 2026 9a-2p 8101 Sandy Springs Rd Laurel, Md 20707 Conference Room #300 Contact us at: exceptionalcprtraining3@gmail.com (540)259-2600
Please Note:
All fees are Non-refundable. -The registration is non-refundable and non-transferable. -The phlebotomy workshop is $300.00 (registration fee is not included). -All fees must be paid in full before the start of class. -In the event of unforeseen circumstances and the class is canceled by the instructor, paid fees will be refunded immediately. -We do not grant credits or discounts to students for other courses taken in the field of Phlebotomy and/or other allied health training.
Attendee Name
First Name
Last Name
Birth Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Occupation
Medical Professional
Healthcare provider
Other
Do you have any prior experience in Phlebotomy?
Please Select
Yes
No
Do you want to attend the CPR AED Renewal class?
My Products
prev
next
( X )
Phlebotomy Workshop registration fee
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Phlebotomy Workshop
$
300.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Credit Card
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Let us know if your interested in booking our small group phlebotomy training.
Submit
Should be Empty: