Clinical Laboratory Day: Yea for QA! A Winning Approach to Quality Assurance

Reserve a seat for this conference by completing the following registration form. This form and a check or money order for $35.00 (payable to Texas Health Institute) must be submitted by September 24, 2010. Mail payment to: NCSLPH, Laboratory Improvement Unit, P.O. Box 28047, Raleigh, NC 27611-8047. Refund Policy: Cancellations prior to the deadline will be refunded minus a $15.00 processing fee. Cancellations after the deadline date will not be refunded. Registrations which cannot be accepted due to over-enrollment will be refunded in full.


A red asterisk (*) indicates required questions.

  1. Last Name (as it should appear on a CE certificate)*


  1. First Name (as it should appear on a CE certificate)*


  1. Organization/Facility*


  1. Mailing Address*


  1. Phone Number


  1. Fax Number


  1. E-Mail Address


  1. Which category best describes your work duties?
    MT/MLT/CLS/CLT
    LPN/RN
    Phlebotomist
    Physician/PA/FNP
    MOA
    Educator
    Student


  1. Request site map for Wake Technical Community College?
    Yes
    No


  1. Request a list of area hotels/motels?
    Yes
    No





Michaela Creech
Laboratory Improvement Coordinator
NC State Laboratory of Public Health
NC