STANDING APPOINTMENT ORDER FORM


P.O.C. Consultants will call your office and make an appointment for the following service(s):

Service Desired

Month/

Year

Best Day

of Week

Best Time

of the Day

Annual OSHA Safety Training (allow 1.5 hours)

 

 

 

CLIA Quality Assurance check and record check (allow 2+ hours)

 

 

 

OSHA Office Review and Manual Upgrade ( 1 hour)

 

 

 

 

Office Name:                                                                          Doctor Name:

Contact Person:                                                                                   Title:

Address:

 

Phone #:                                                                                              Fax #:

 

The fee for OSHA Safety Training is $175 for the first 5 students, and $10 for each additional student. 

Our hourly fee for evaluation/review services is $175/hr .  There may be additional charges for OSHA manual upgrade pages, review of manual  and Quality Assessment plans.

 

P.O.C. also charges a modest $30 fee to visit offices that are over 30 miles, $40 over 40, $50 for offices over 50 miles (and so on)  away  from our nearest consultant.  This fee is paid to our consultant to defray the cost and time for travel.  A fee of $50 will be added for appointments requested before 9AM and after 5PM.

* Prices in effect as of January 1, 2016