Get Registration Form For - Ncdhhs

Filling out the Registration Form for N.C. Health Check Seminar is a straightforward process. This guide provides step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to complete the registration form online.

1. Click ‘Get Form’ button to obtain the registration form and open it for editing.
2. Enter your provider name and discipline in the designated field to identify your service qualifications.
3. Input your Medicaid provider number and NPI number, ensuring that these identifiers are accurate to avoid any processing issues.
4. Fill in your mailing address, including the city, zip code, and county. This information is essential for correspondence.
5. Specify the contact person for this registration. This should be someone knowledgeable about the submission and can be reached for any follow-up.
6. Provide the email address and telephone number for the contact person. Make sure these are up-to-date for effective communication.
7. Indicate the number of attendees who will participate in the seminar by selecting either one or two.
8. Select the preferred seminar date and location from the provided options to finalize your attendance.
9. After completing the form, you can choose to save changes, download a copy for your records, print the form, or share it as required.

Complete your registration form online today to secure your place at the seminar.