National Association of Psychiatric Health Systems

Order Form 

Please Print This Form and Return To:
NAPHS, 701 13th Street, NW, Suite 950
Washington, DC 20005-3903
FAX: 202/783-6041
QUESTIONS: Call 202/393-6700, Ext. 106

Audiotape / Notebook On Outpatient PPS
for behavioral healthcare providers

Your Name
Affiliation
Street
City, State, Zip
Phone
E-mail

Audiotape/handout packages:

NAPHS members: $125
Non-member:$175

SPECIAL DISCOUNT TO TELECONFERENCE PARTICIPANTS: Participants in the June 7, 2000, or June 16, 2000, NAPHS-sponsored teleconferences on outpatient PPS are eligible for an additional discount on the audiotape/handout package. Check here if you are:

NAPHS member who participated in June teleconference:
          $30 discount

Non-member who participated in June teleconference:
          $25 discount

TOTAL PAYMENTS ENCLOSED (payable to NAPHS):

OR PAY BY CREDIT CARD  
(Mastercard and Visa accepted):
Credit Card 
Account Number:
  Name of Account Holder
Signature
Expiration Date

 

 


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NAPHS
701 13th Street, NW, Suite 950
Washington, DC 20005-3903
Phone: 202/393-6700
Fax: 202/783-6041
E-mail:  naphs@naphs.org