Tel: 352-256-6082 ▪ Fax: 352-373-6451 ▪ Email:

/ Cynthia Barnett, M.A., CCC-SLP, BRS-S
ProCourse
PO Box 15023, Gainesville, Florida 32604 /

Registration & Order Form-home/study courses- Please print or type legibly

Name:
Address:
City: / State: / ZIP:
Email address: / Phone:
checks made out to proCourse
If Faxing,scanning, etc. please enter the following credit card information
Type of card .______Number ______EXP ___/____
Billing address ______Billing zip code______
Course Name / Fee /  / CEUs
Ethical and Effective Speech-Language Pathology Services / $ 60 / 2 hours(Texas AND Wisconsin requirement)
Ethical and Effective Speech-Language Pathology Services Renewal*
/ $ 10 / 2 hours
Comprehensive Compendium for Dysphagia Management / $175 / 10 hours
Comprehensive Compendium Renewal*
/ $ 40 / 10 hours
Introduction to Endoscopy / $150 / 8 hours
Introduction to Endoscopy Renewal*
/ $ 40 / 8 hours
Prevention of Medical Errors for Speech Language Pathologists
/ $ 60 / 2 hours (Florida requirement)
Prevention of Medical Errors for Speech Language Pathologists Renewal*
/ $ 10 / 2 hours
Prevention of Medical Errors for Audiologists-
/ $ 60 / 2 hours (Florida requirement)
Prevention of Medical Errors for Audiologists Renewal*
/ $ 10 / 2 hours
Activities for Speech Language Pathologists
/ $110 / 8 State FL .5 ASHA
Activities for Speech Language Pathologists Renewal*
/ $ 15 / Same as above
More Activities for Speech Language Pathologists Book #2
/ $150 / 8 hours
Activities for Speech Language Pathologists Book #2 Renewal*
/ $ 15 / 8 hours
HIV for Healthcare Providers
/ $ 30 / 2 hours
HIV for Healthcare Providers Renewal*
/ $ 10 / 2 hours
Blood Borne Pathogens-State of Florida requirement in some counties-hard copy only ($10 shipping-this course only)
/ $ 15 / 1 hour
Blood Borne Pathogens Renewal $5 1 hour
*You must already have completed a course once to purchase the course renewal for credit. Renewals may be done in the next licensure period.
Course Total:
/ $
Shipping and Handling, $12.45 per course or $5.65 per renewal. Call Cindy when ordering multiple courses for shipping fees and discounted shipping for more than 1 course. (All shipping costs are based on USPS Flat Rate boxes.
Ie Prevention of Medical Errors and HIV courses are $12.35 shipping total.) / $
/
Total Check:
/ $

CONTACT CINDY AT EMAIL ABOVE FOR NEW POST TEST AND ASHA BUBBLE SHEET FOR RENEWALS.

MOST OF IT CAN BE DONE BY EMAIL TO AVOID SHIPPING COSTS FOR RENEWALS.