Group Purchase Payment Form

Group purchase of additional on-demand course licenses

To help our team to process your payment, please use the same group name from your previous group orders.

Please contact 904-800-1237 or info@pbieducation.com with any questions regarding submitting payment.

Group/organization Name(Required)

Group ID

Your Name(Required)

First Last

Your Title

Your Department

Your Email(Required)

Your Phone Number(Required)

Please type in the quantity box below each course the number of course licenses you would like to add.

CTP-2

Price: $55.00

PBI Navigating Professional Boundaries in Health Care (DR-2/NDR-2)

Price: $55.00

Managing Clinician-Patient Conflicts (CPC-2)

Price: $55.00

Total

Hidden

Website(Required)

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Terms and Policies(Required)

I agree to PBI’s Terms and Policies.

Credit Card

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