Fill out this form, print it out, and fax to McVey Associates at 415-892-1271.

Registration Form for the Reimbursement, Coding & Compliance Seminar

for Orthopedic Surgery


Session:

How many people will be attending?

The cost is $255 for the first person and $230 for each additional person. The fee includes workbook, all materials and refreshments. Your registration will be confirmed by return fax.


Name:

Name of Doctor/Group/Clinic:

Street Address:

City, State, Zip:

Office Phone Number: Fax Phone Number:

You can pay by credit card.

Credit Card: AMEX Mastercard Visa Discover Card

Expiration Date:

Signature:

Or, make check payable and mail, with registration form, to:

McVey Associates, Inc.
150 Ford Way, Suite 100
Novato, CA 94945