CODING SCHOOL REGISTRATION FORM

*Please print, fill-in, and fax registration form

CPC Course Applicant _______ initials                                   

CPC Seminar Applicant _______ initials

Name:_____________________________

Organization: __________________________________

Address: __________________________________

City: __________________________________

State :____________ Zip: _____________     

Home Phone:____________________________  

Business Phone:_____________________

Email: _____________________________

 Payment plans(circle one): 

[A] $129.20 weekly

[B] $258.33 bi-weekly

[C] $387.50 monthly

You will receive a confirmation of your registration by mail or email. Please complete one form per participant.   

Call for more information on class content.. 

Please call P M C I for additional information via email, see below

Mail the registration form with payment information or email Instructor@codingschool.net for further instruction on how to register.

Note: Classes to be held at the University of Phoenix- Pasadena, CA, but all correspondence to be directed to Professional Medical Coders Institute

Medical Coding Students must provide the following books and information prior to class and Seminar Registrants are encouraged to bring the current coding books listed below:

• 2012 CPT-4
• 2012 ICD-9-CM
• 2012 HCPCS
  • Current Medical Dictionary (optional)
  • Call PMCI for discount before ordering coding books!