Central Business School Enrollment Form for Continuing Education Courses

	Central Business School Experts in the business of healthcare for over 18 years!

Continuing Education Courses Enrollment Form
Applicant Name:
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Birth date:		Soc. Sec. #:
CEU101	Outpatient Coding and Reimbursement for Hospital Services, Part 1, using 2012 ICD-9-CM, Volumes 1 & 2, and 2012 CPT/HCPCS, 30 hours		$195
CEU102	Outpatient Coding and Reimbursement for Hospital Services, Part 2, using 2012 ICD-9-CM, Volumes 1 & 2, and 2012 CPT/HCPCS, 30 hours		$195
CEU103	Outpatient Coding and Reimbursement for Hospital Services, using 2012 ICD-9-CM, Volumes 1 and 2, and 2012 CPT/HCPCS, with certification preparation, 30 hours		$195
CEU104	Inpatient Coding and Reimbursement for Hospital Services, Part 1, using 2012 ICD-9-CM, Volumes 1, 2, and 3, 30 hours		$195
CEU105	Inpatient Coding and Reimbursement for Hospital Services, Part 2, using 2012 ICD-9-CM, Volumes 1, 2, and 3, 30 hours		$195
CEU106	Inpatient Coding and Reimbursement for Hospital Services, using 2012 ICD-9-CM, Volumes 1, 2, and 3, with certification preparation, 30 hours		$195
CEU107	Physician Coding and Reimbursement, using 2012 ICD-9-CM, Volumes 1 and 2, and 2012 CPT/HCPCS, Part 1, 30 hours		$195
CEU108	Physician Coding and Reimbursement, using 2012 ICD-9-CM, Volumes 1 and 2, and 2012 CPT/HCPCS, Part 2, with certification preparation, 30 hours		$195
CEU109	Human Anatomy & Physiology for ICD-10-CM, 30 hours		$195
CEU110	Human Anatomy & Physiology for ICD-10-PCS, 30 hours		$195
CEU111	ICD-10-CM for Inpatient Coders, 30 hours		$195
Approved through Association for Healthcare Documentation Integrity (AHDI) for 10 CEUs per course - the maximum allowable per course)			Total:
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Terms: All tuition and fees paid by the applicant shall be refunded if the applicant is rejected by the school before enrollment. An application fee of not more than $25.00 may be retained by the school if the application is denied. All tuition and fees paid by the applicant shall be refunded if requested within three business days after signing a contract with the school. All refunds shall be returned in 30 days. A Central Business School certificate is awarded upon successful completion of each Continuing Education course. The allowable completion time for each Continuing Education course is 12 weeks from the date of enrollment. Your signature below indicates you understand and agree to the terms of this enrollment agreement.
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Please enroll by filling out this form, signing the form, and mailing with payment to: Central Business School PO Box 1081 Marquette, MI 49855 or email to info@centralbusinessschool.com or Use the PayPal option on the program pages, if desired, to enroll with PayPal or credit card. Please also mail or email enrollment form when registering via PayPal.			Questions? Please email Central Business School or Call 906.226.0169