Teleconference Registration Form

Diversity and End-of-Life Care

At most teleconference sites, continuing education contact hours (CEs) will be available through The Hospice Foundation of America for nurses, social workers, counselors, funeral directors, clergy, psychologists, physicians, EMS personnel, EAPs and nursing home administrators. Please verify CE availability at your local site and your professional or state board approval. There is a $25 online processing fee per certificate, per participant. The processing fee through the mail with HFA is $35. There is a $10 charge per participant for each additional certificate requested.

Items with an * indicate a required field.

First Name *
Middle Name
Last Name *
Address Line 1 *
Address Line 2
City
State
Zip
Country
Phone
Email *
Occupation
I would like CE Credit for:
Passes are pre-paid - please return registration form by April 17th to ensure mail out of pass to you	I will need a parking pass

Click on the Submit Button to Register !!