Registration Form Please fill out the form before proceeding to payment Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Layout*Course: Certified Patient Safety Specialist (CPSS)Certified Medication Safety Officer (CMSO)Certified Hospital Accreditation Officer (CHAO)Certified Professional in Healthcare Management (CPHMG)Certified Professional in Healthcare Performance Improvement (CPHPI)Certified Healthcare Risk Management Officer (CHRMO)Certified Professional in Infection Control (CPIC)Certified Healthcare Quality Officer (CHQO)Layout*First Name: **Surname: *Layout*Email: *LayoutPhone:Layout*Name as you would like it on your certificate:LayoutBirth date MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920LayoutNationality:*Current Position:*Institution/Organization:*Address:LayoutZip Code / Postcode:CityLayout*Country:Go To Secure Payment “11/23/2025” has been added to your cart. Continue shopping Remove item Thumbnail image Product Price Quantity Subtotal × 11/23/2025 800,00 $ 11/23/2025 quantity 800,00 $ Update Cart Apply coupon Cart Totals Subtotal 800,00 $ Total 800,00 $ Proceed to Checkout
