Course Registration Form

Please fill out the form below to register for our upcoming courses. If registering multiple participants, please fill out separate forms for each participant. In 1-2 business days after submitting this form, you will receive a confirmation email with your invoice and payment remittance instructions. We accept checks, most major credit cards and wire transfers.

If you have any questions, please feel free to call our office at 800-736-6334. Thank you!

NOTE: Due to the COVID-19 pandemic, we are reducing the amount of students per class. If a course is marked FULL, you can submit the registration form to be placed on a wait list. If a spot opens or a new course date is scheduled, you'll be notified as soon as possible.

If Billing information is different from participant's information, please include it here, as well as any other information we may need to know about the participant. If you are registering for a Hearing Recertification course, please include your CAOHC certificate number and date of last course here.

* This training is valid for five years (NIOSH guideline as of 1/1/2009).

** To attend a 2-day recertification course, the participant must have attended a previous course instructed by Palmer Associates to qualify for the $475.00 rate. This training is valid for five years.

*** Registration for this course is required to become certified with the Council for Accreditation in Occupational Hearing Conservation (CAOHC). This certification is valid for five years.

**** The Council for Accreditation in Occupational Hearing Conservation (CAOHC) requires attendance at a one day recertification course every five years to maintain CAOHC certification status. The participant, not MEDI, is responsible for ensuring eligibility for recertification. There is no grace period. However, extensions can be requested up to 30 days before certification has expired (shown on certificate). An extension may be requested by contacting CAOHC directly (414-276-5338 or www.caohc.org).

PLEASE NOTE: Course fees include CAOHC Certification and MEDI Course manuals. Course fees do not include the CAOHC course manual. CAOHC course manuals are an optional additional resource and are available for $80.00 each. To purchase, call MEDI at 1-800-736-6334 or click here.

*****This course is for users of the CMI Intoxilyzer 400 ONLY. BAT courses are one day, lasting from 8:30 a.m. to approximately 5:00 p.m. They will be held at DISA, INC. at 538 Stone Road, Ste. G, Benicia, California 94510. The Train-the-Trainer courses require a second day of instruction from 9:00 a.m. to approximately noon at MEDI's location at 4814 East 2nd Street, Benicia, CA 94510. There is a required licensing fee with CMI. This agreement is for two years. To qualify for this training, the participant’s company must be prepared to comply with a training licensing agreement and a propriety information agreement with CMI prior to the first day of the course.

ONLY 1 SPOT LEFT!

ONLY 1 SPOT LEFT!

 

4814 East Second Street

Benicia, CA 94510


T: 1-800-736-6334 or 510-459-0741
F: 707-746-6374


info@medi6334.com

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