Forum and Mini-Forum Subscription Form

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HFMA Member #
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*E-mail Address



Forums Subscriptions
Forum	HFMA Member Price (prorated thru 5/31/10)	HFMA Non-Member Price (12 months from date of sign-up)

Healthcare Compliance Forum	$55.00	$150.00
CFO Forum	$55.00	$150.00
Managed Care Forum	$55.00	$150.00
Revenue Cycle Forum	$55.00	$150.00
Physician Alignment Forum	$55.00	$150.00
Medicare Payment Forum	$55.00	$150.00

Mini-Forums Subscriptions
Mini-Forum	HFMA Member Price (12 months from date of sign-up)	HFMA Non-Member Price (12 months from date of sign-up)
Electronic Health Records Mini-Forum	$49.00	$79.00
RAC Mini-Forum	$49.00	$79.00
Total

**If you are paying by check please print out this page and send it with your payment to HFMA, Dept. 77-5195, Chicago, IL 60678-5195. Make your check payable to HFMA.