Registration by Invoice

Continuing Education Registration Form

Please complete the information below to register for Pomphrey Consulting education programs and webinars. Registration must be completed at least five days prior to the course start date. All communications, including login credentials and important notices, will be sent exclusively via email. Some hospital security systems may block external emails—please check your spam folder and, if necessary, contact your IT department to add Pomphrey Consulting to your safe sender list.

Institution Information

* Indicates required field

Hospital/Institution Name *

Manager's Name *

First

Last

Manager's Email Address *

Attendee Information

Month You Plan to Attend *

Participant Name *

First

Last

Work Email *

Course Credit Needed *

Courses

Choose from the options below to complete your registration for the selected courses or webinars.

Beginning Trauma Registrar Courses *

Advanced Trauma Registrar Courses *

Trauma Program Manager Courses *

Webinars

Trauma Registrar Webinars *

Payment & Billing Information

Billing Name / Institution *

First

Last

Billing Phone Number *

Billing Address *

Line 1

Line 2

City

State

Zip Code

Country

Billing Email *

Pomphrey Consulting Training
Program Confidentiality Code

I hereby affirm that I have registered and remitted payment for the Pomphrey Consulting Trauma Registrar Specific Training Program, thereby obtaining the right to access all associated course materials. I further agree that I will neither provide nor accept unauthorized assistance in the completion of any coursework, and I shall not copy, share, or otherwise distribute any course materials in any form.

By entering my full name as my signature, I confirm that I have read and agree to the Pomphrey Consulting Training Program Confidentiality Code. *

First

Last

Date *

To reserve your spot and ensure timely delivery of course materials, please complete your registration and submit payment by the deadline for your selected course. You will receive a welcome email within 48 hours after your registration is processed.
Registration is not confirmed until the completed form and all required fees have been submitted, and the minimum enrollment for the course has been met.
All courses provide continuing education contact hours. One contact hour equals 60 minutes of structured learning, which may include didactic instruction or clinical experience.

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Don't just take our word for it.
Our clients have something to say...

“I came in to this hospital and trauma program late in the game after much of the work had already been done by the Pomphrey consulting team. Under Michelle’s guidance, this team was able to diligently work to meet our needs in preparing for Trauma verification survey. I feel that this team’s work is a direct reflection of the success of our trauma verification. Michelle is a consummate professional and she knows the formula to helping other trauma programs succeed. I was impressed with her background and knowledge and felt comfortable putting our delicate program in her hands. I have already recommended her services to my colleagues.

-Jennifer Wobig, RN, BSN, Trauma Program Manager, Cottage Health System, Santa Barbara, CA

Continuing Education Registration Form

Institution Information

Attendee Information

Courses

Webinars

Payment & Billing Information

Pomphrey Consulting Training
Program Confidentiality Code

Don't just take our word for it.
Our clients have something to say...

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