Email
Membership Please select Member Non-Member
First Name
Last Name
RHC/Organization Name:
Phone Number
Mailing Address
City
State
Zip Code
Payment Information
Early Bird Registration
First 100
On-Time Registration
Ends Sept. 4
Late Registration
Sept. 5-30
NARHC Member
$525
$575
$625
Non-Member
$625
$675
$725
Packages Select Package Onsite Registration - Already Paid
0.0
0.0
Payment Section Select Payment Method Authorize.net (Authorize.net)
Please let us know in advance if you require wheelchair access.
Food Allergies/Restrictions
Do you plan on attending Monday’s luncheon? Please select Yes No
Do you intend on attending Wednesday's sessions? Please select Yes No Some, but not all
How did you hear about our conference? Please select Attended previously CRHCP Facebook LinkedIn NARHC Email NARHC Forum NARHC Website NARHC Newsletter Word of Mouth Other
Gender Please select Female Male Prefer not to answer
Age Please select up to 30 31-35 36-40 41-45 46-50 51-55 56-60 61+ Prefer not to answer
Job Category Please select Association/SORH Personnel Billing & Coding Clinic Manager/Administration Clinic Owner Compliance/Quality Consultant Hospital/Health System Administration (CEO, CFO, COO, Director, etc.) Medical Staff (RN, MA, CNA, etc.) Office Staff (Office Manager, Admin Assistant, Office Secretary, etc.) Provider Social Worker Other
Please Specify the job category
Attendee Badge/APP Information Information used in our Event App is visible to those who register for either conference.
Preferred Name
Job Title
Credentials
Organization Type Please select Independent RHC Provider Based RHC Hospital Health System Government Association Consultant
Name of RHC/Organization
RHC/Org’s City & State
Cell Phone # (will not be displayed)
Lunch Table
Registrants of the conference will receive an email from our NEW event app vFairs with your login information prior to the start of the conference. For those who have not used our app previously, this is a vital piece that will enhance your experience at our conference. It will also allow you to have the chance to be entered into the conference prize drawings! It is important that you allow notifications from the app.
NARHC reserves the right to use any photographs/video taken during the conference for promotional purposes. By submitting this form, you agree to be photographed and understand the cancellation policy.
