Cpc Code Breakers, Llc

CPC CODE BREAKERS, LLC

AAPC Professional Medical Coding Curriculum

FALL 2011 – CLAWSON/TROY/ROYAL OAK AREA

THURSDAY CLASS - REGISTRATION FORM

*Class size limited to 14 maximum - register early! Registration Deadline: *

Please complete form; send with $275.00 class deposit (Cashier’s Check, Money Order or Company Check only) payable to:
Elizabeth Zahodne
1924 Wickham Street
Royal Oak, MI 48073
(248) 632-1205
/ Which class are you interested in taking?
Beginning Class
Includes Intro to Medical Terminology, Anatomy & Physiology, plus Intermediate Class below / ______
OR
Intermediate Class / ______
First Name / Last Name
Address
City, State, Zip Code
Home Phone / Cell Phone / Work Phone
Home E-mail Address / Employer
Work E-mail Address / Employer Address
Occupation
Please list # of years of experience below, as applicable:
Experience / # of Years / Experience / # of Years / Experience / # of Years
Medical Coding:
/ Medical Billing: / Medical Insurance:
Nursing: / Medical Assisting: / Medical Office or
Unit Clerk:
Other Medical Experience: (Please Specify) ______
Have you had Medical Terminology? / Have you had Anatomy and/or Physiology?
Are you a current AAPC member? / How did you hear about this class?
____ AAPC Website _____ Employer, Co-Worker
____ Family, Friend _____ Other ______
Do you need to purchase any coding manuals from instructor? Please circle which manuals you need below:
All (3) manuals CPT ICD-9-CM HCPCS