On-Line Request for Registration for Save Dollars, Avoid Denials

Home Provider Part B Education Education Schedule

Please enter your registration information below. Note: When a confirmation e-mail for this seminar is sent from WPS Medicare it will come from a mailbox named medsem.b.enroll@wpsic.com.

Registration Information

Name of Company or Provider:*
Company or Provider Specialty:
Company or Provider Address:*
City, State, Zip:
Phone Number:*	( )
Fax Number:	( )
Contact E-mail Address*:
Confirm E-mail Address*:
Your Name or Contact Name:*
Note: Maximum number of attendees per group/organization is three.
Attendee 1:*
Attendee 2:
Attendee 3:

         

By submitting your e-mail address, you are allowing WPS to send this e-mail address information on Medicare rules, regulations, and current seminars. WPS is the only entity that will use this address. If you do not want to receive this information, please follow the disenrollment directions within your first e-mail or let us know within your submission.

Page Last Updated: Thursday, 18-Mar-2010 05:56:57 CDT