Creative Health Care Management


Registration



One Day Early Bird Rate
One Day Standard Rate
3 Day Standard Rate
5 or more Participants:
$200/person
$200/person
$1,000/person
Fewer than 5 Participants:
$200/person
$200/person
$1,000/person
Registration Opens:
03/06/2019
03/06/2019
03/06/2019
Registration Closes:
10/28/2019
10/28/2019
10/28/2019


If you have any questions please contact: registration@chcm.com or call 800-728-7766
Payment methods accepted - Visa, Mastercard, Discover, American Express

Instructions for filling out this form:
-Enter your information using proper case.
-Do not use ALL CAPITAL OR ALL LOWERCASE LETTERS!
-This data will be used to generate your name badge.

Will you be attending One Day or
Three Days at the Annual Gathering?

If attending ONLY the one-day summit 10/28/2019, check ‘One Day’ (open to all health care workers).
If you are a CHCM certified facilitator for Re-Igniting the Spirit of Caring, Leading an Empowered Organization, See Me as a Person or Relationship-Based Care Program Lead you will need to attend all three days (10/28-30/2019), so check ‘Three Days'.

Oct. 28 ($200)
Oct. 28-30 ($1,000)
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