EDI Payor Agreements Training

Organization:

Full Name:

Title:

Department:

Address:

Address 2:

City:

State:

Customer ID:

Email:

Phone:

Full Name:

Title:

Department:

Email:

Phone:

Choice 1:

Monday, 4/30/12: 9:30 a.m. – 11:00 a.m. EST
Wednesday, 5/9/12: 1:30 p.m. – 3:00 p.m. EST
Thursday, 5/17/12: 12:30 p.m. – 2:00 p.m. EST
Tuesday, 5/22/12: 10:30 a.m. – 12:00 p.m. EST
Tuesday, 5/29/12: 11:30 a.m. – 1:00 p.m. EST

Choice 2:

Monday, 4/30/12: 9:30 a.m. – 11:00 a.m. EST
Wednesday, 5/9/12: 1:30 p.m. – 3:00 p.m. EST
Thursday, 5/17/12: 12:30 p.m. – 2:00 p.m. EST
Tuesday, 5/22/12: 10:30 a.m. – 12:00 p.m. EST
Tuesday, 5/29/12: 11:30 a.m. – 1:00 p.m. EST

Client Information
Organization:
Trainee Information
Full Name:
Title:
Department:
Address:
Address 2:
City:
State:
Customer ID:
Email:
Phone:
Additional Trainee Information
Full Name:
Title:
Department:
Email:
Phone:
Schedule Selection
Choice 1:	Monday, 4/30/12: 9:30 a.m. – 11:00 a.m. EST Wednesday, 5/9/12: 1:30 p.m. – 3:00 p.m. EST Thursday, 5/17/12: 12:30 p.m. – 2:00 p.m. EST Tuesday, 5/22/12: 10:30 a.m. – 12:00 p.m. EST Tuesday, 5/29/12: 11:30 a.m. – 1:00 p.m. EST
Choice 2:	Monday, 4/30/12: 9:30 a.m. – 11:00 a.m. EST Wednesday, 5/9/12: 1:30 p.m. – 3:00 p.m. EST Thursday, 5/17/12: 12:30 p.m. – 2:00 p.m. EST Tuesday, 5/22/12: 10:30 a.m. – 12:00 p.m. EST Tuesday, 5/29/12: 11:30 a.m. – 1:00 p.m. EST

EDI Payor Agreements Library Training Registration