• FACILITY REGISTRATION FOR EDCOR CLASSES

    For HealthONE Physician Services - Please complete, print for signatures and fax or email to EdCor: 303-993-4378 or edcor.sherri@gmail.com


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  • (FOR MANAGER TO COMPLETE AND SIGN)

    I verify payment for this class for the above individual.  I understand, per the Cancellation Policy, the facility will be charged if the employee does not cancel within 48 hours of the class or does not show to the class. 

    Will your facility pay for the book (circle one)? YES     NO    We have a book for the employee

    Signature of Manager: _______________________________________________

    Email: _________________________________________

    Site: ______________________________________________COID#:____________________

    I would like a copy of the ecard ID# sent to me also at the above email.  YES    NO

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