Professional Supervisor of the Audiometric Monitoring Program for Certification and Course Registration

  

Work Address

Home Address


Indicate any current professional licensure or registrations, with dates awarded.

  1. I agree that CAOHC may verify any information provided in this application.
  2. I understand that I must continuously hold licensure as a physician or audiologist for the duration of the certification in order to retain CAOHC certification as a Professional Supervisor of the Audiometric Monitoring Program (CPS/A). CPS/A certification is five years.

Workshop Registration

How did you hear about the workshop?

Payment Information

$

* indicates required field

CAOHC
555 E. Wells Street, Suite 1100, Milwaukee, WI 53202-3823
Phone: 414/276-5338 Fax: 414/276-2146 info@caohc.org

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