2015 LMG Education Center Training Class Schedule

2015 LMG Education Center Training Class Schedule

Class Pricing Medical Assistant (MA) Training Class Includes in-house certification, CPR certification, and national certification testing after 1 year experience. 20 days $3,000 (discounted to $2,000 for LMG employees for 2014) Phlebotomy Training 2 days $500 IV Training 2 days $500 National Testing & Certification (in your area of expertise) Choose from Medical Assistant, Phlebotomy, Billing/Coding. 2 days $500 Basic Life Support CPR /AED (BLS) *Recommended for Healthcare Professionals* 4 hours $90 Heartsavers CPR/AED (non-medical staff and community) 4 hours $70 To register for classes email Learn@LMGDoctors.com or call 571.209.1850. Visit us at www.lmgeducationcenter.com

January 2015 January 5, 6, 7, 8, 12, 13, 14,15, 19, 20, 21, 22, 26, 27, 28, 29 February 2, 3, 4,5 January 10, 11 IV Therapy Training Class January 17, 18 National Workshop and Testing 9AM-12PM Workshop, 10AM-12PM Testing January 24, 31 February 2015 February 16, 17, 18, 19, 23, 24, 25, 26 March 2, 3, 4, 5, 9, 10, 11, 12, 16, 17, 18, 19 February 14, 15 BLS CPR/AED 9AM-1PM February 7 National Workshop and Testing 9AM-12PM Workshop, 10AM-12PM Testing February 21, 28

March 2015 See February March 14, 15 IV Therapy Training Class March 21, 22 National Workshop and Testing 9AM-12PM Workshop, 10AM-12PM Testing March 28, April 4 BLS CPR/AED 9AM-1PM March 21 April 2015 March 30, 31 April 1, 2, 6, 7, 8, 9,13, 14, 15, 16, 20, 21, 22, 23, 27, 28, 29, 30 April 11, 12 National Workshop and Testing See March

May 2015 May 11, 12, 13, 14, 18, 19, 20, 21, 25, 26, 27, 28 June 1, 2, 3, 4, 5 May 9, 10 IV Therapy Training Class May 16, 17 BLS CPR/AED Training Saturday 10AM-2PM May 5 National Workshop and Testing 9AM-12PM Workshop, 10AM-12PM Testing May 23,30 June 2015 June 22, 23, 24, 25, 29, 30 July 1, 2, 6, 7, 8, 9, 13, 14, 15, 16, 20, 21, 22, 23 June 13, 14 BLS CPR Training 10AM-2PM June 13 National Workshop and Testing 9AM-12PM Workshop, 10AM-12PM Testing June 20, 27

July 2015 See June July 11, 12 IV Therapy Training Class July 18, 19 National Workshop and Testing 9AM-12PM Workshop, 10AM-12PM Testing July 25, August 1 BLS CPR Training 10AM-2PM July 25 August 2015 August 3, 4, 5, 6, 10, 11, 12, 13, 17, 18, 19, 20, 24, 25, 26, 27 September 1, 2, 3 August 8, 9 September 2015 September 14, 15, 16, 17, 21, 22, 23, 24, 28, 29, 30 October 2, 5, 6, 7, 8, 12, 13, 14, 15 September 12, 13

National Workshop and Testing 9AM-12PM Workshop, 10AM-12PM Testing September 36, October 3 BLS CPR/AED Training Saturday 10AM-2PM September 5 October 2015 See September October 10, 11 BLS CPR/AED Training Saturday 10AM-2PM October 17 November 2015 October 26, 27, 28, 29 November 2, 3, 4, 5, 9, 10, 11, 12, 16, 17, 18, 19, 23, 24, 25, 26 November 14, 15 IV Therapy Training Class November 21, 22 BLS CPR/AED Training Saturday 10AM-2PM November 28

December 2015 December 7, 8, 9, 10, 14, 15, 16, 17, 21, 22, 23, 24*, 28, 29, 30, 31* December 12, 13

NON-REFUNDABLE DUES 1. Tuition is non-refundable. No refunds will be issued. Student may apply paid tuition to other classes within lmg education center within seven days before start date. 2. After start date no refunds are issued. The student is responsible for entire balance of tuition even if no longer attending class. 3. The student is responsible for employment. Loudoun medical group education center does not guarantee, promise or provide employment after completing classes. 4. Payment is due regardless even if student fails to complete or pass the program. 5. If the program is cancelled by the lmg education center, refunds will be at the discretion of Loudoun Medial Group, P.C. and may include partial or full refunds based on percentage of program completed. Additionally, credits for future programs may be substituted. Print Student Name: Student Signature: Date:

Loudoun Medical Group Education Center 224-D Cornwall St. NW, Suite 401, Leesburg, VA 20176 Telephone 571.209.1850 Fax 703.443.1265 Attention: Angie Bentley Email: Learn@lmgdoctors.com MEDICAL ASSISTANT TRAINING PROGRAM ENROLLMENT FORM Student Name: Address: Cell Phone Number: Email Address: LMG Employee: Yes No If Yes, Practice Name: 2015 MEDICAL ASSISTANT TRAINING PROGRAM DATES January 5 February 5 February 16-March 19 March 30- April 30 May 11 June 11 June 22 July 23 August 3 September 3 September 14- October 15 October 26- November 26 December 7- January 7th Community & Non- LMG Employees Total Program Including Book & CPR Training $3,000 $500 Deposit (Cannot be payroll deducted) Cash Check Credit Card $2,500 Remaining Balance Cash Check Credit Card THIS SECTION IS FOR CURRENT LMG EMPLOYEES ONLY LMG Employees Total Program Including Book & CPR Training $2,000 $2,000 Cash Check Credit Card Other Payment Plan (must be paid in full before certificate will be issued) $ every weeks by Cash Check Credit Card LMG Employee Payroll Deduction Options $100 Per Pay Period (20 paychecks for a total of $2,000) If an LMG practice paying for any portion of your training as your employer, please specify amount? Yes $ Signature of Approving Manager or Physician: I consent to the above payroll deductions to begin on my next pay period. If my employment at Loudoun Medical Group is terminated or I resign prior to paying off the above amount, I am aware that the remaining balance will be deducted from my final paycheck. Employee Signature: Date: Print Employee Name: CREDIT CARD INFORMATION Name on card Amount to Charge: Cardholder Mailing Address: Type of card: MC Visa Discover AMEX Card Number Expiration date CV Code How did you hear about the LMG Education Center? Flyer at LMG Practice LMG Website Newspaper Ad Craigslist Payroll Stuffer Other FOR USE BY LMG EDUCATION CENTER ONLY PAID IN FULL: Date Amount $ Employee Initials

Loudoun Medical Group Education Center 224-D Cornwall St. NW, Suite 401, Leesburg, VA 20176 Telephone 571.209.1850 Fax 703.443.1265 Attention: Angie Bentley Email: Learn@lmgdoctors.com PHLEBOTOMY TRAINING PROGRAM ENROLLMENT FORM Student Name: Address: Cell Phone Number: Email Address: LMG Employee: Yes No If Yes, Practice Name: 2015 PHLEBOTOMY TRAINING PROGRAM DATES January 10 & 11 February 14 & 15 March 14 & 15 April 11 & 12 May 9 & 10 June 13 & 14 July 18 & 19 August 8 & 9 September 19 & 20 October 10 & 11 November 14 & 15 December 12 & 13 Community & Non-LMG Employee - Total Program Including Book $500 $500 Cash Check Credit Card THIS SECTION IS FOR CURRENT LMG EMPLOYEES ONLY Current LMG Employee - Total Program Including Book $500 $500 Cash Check Credit Card Payroll deduction (see below) LMG Employee Payroll Deduction Options $50 Per Pay Period (10 paychecks for a total of $500) $100 Per Pay Period (5 paychecks for a total of $500) If an LMG practice paying for any portion of your training as your employer, please specify amount? Yes $ Signature of Approving Manager or Physician: I consent to the above payroll deductions to begin on my next pay period. If my employment at Loudoun Medical Group is terminated or I resign prior to paying off the above amount, I am aware that the remaining balance will be deducted from my final paycheck. Employee Signature: Date: Print Employee Name: CREDIT CARD INFORMATION Name on card Amount to Charge: Cardholder Mailing Address: Type of card: MC Visa Discover AMEX Card Number Expiration date CV Code How did you hear about the LMG Education Center? Flyer at LMG Practice LMG Website Newspaper Ad Craigslist Payroll Stuffer Other FOR USE BY LMG EDUCATION CENTER ONLY Payroll Deduction Approved: Date Amount $ Employee Initials PAID IN FULL DATE Employee Initials

Loudoun Medical Group Education Center 224-D Cornwall St. NW, Suite 401, Leesburg, VA 20176 Telephone 571.209.1850 Fax 703.443.1265 Attention: Angie Bentley Email: Learn@lmgdoctors.com IV THERAPY TRAINING ENROLLMENT FORM Student Name: Address: Cell Phone Number: Email Address: LMG Employee: Yes No If Yes, Practice Name: National Test Type: Medical Assistant Phlebotomy Billing/Coding IV THERAPY TRAINING DATES January 17 & 18 March 21 & 22 May 16 & 17 July 18 & 19 September 16 & 20 November 21 & 22 Community & Non-LMG Employee - Total Program Including Book $500 $500 Cash Check Credit Card THIS SECTION IS FOR CURRENT LMG EMPLOYEES ONLY Current LMG Employee - Total Program Including Book $500 $500 Cash Check Credit Card Payroll deduction (see below) LMG Employee Payroll Deduction Options $50 Per Pay Period (10 paychecks for a total of $500) $100 Per Pay Period (5 paychecks for a total of $500) If an LMG practice paying for any portion of your training as your employer, please specify amount? Yes $ Signature of Approving Manager or Physician: I consent to the above payroll deductions to begin on my next pay period. If my employment at Loudoun Medical Group is terminated or I resign prior to paying off the above amount, I am aware that the remaining balance will be deducted from my final paycheck. Employee Signature: Date: Print Employee Name: CREDIT CARD INFORMATION Name on card Amount to Charge: Cardholder Mailing Address: Type of card: MC Visa Discover AMEX Card Number Expiration date CV Code How did you hear about the LMG Education Center? Flyer at LMG Practice LMG Website Newspaper Ad Craigslist Payroll Stuffer Other FOR USE BY LMG EDUCATION CENTER ONLY Deposit Received: Date Amount $ Payment Method: Credit Card Processed Check Deposited Cash Deposited Employee Initials Payroll Deduction Approved: Date Amount $ Employee Initials PAID IN FULL DATE Employee Initials

Loudoun Medical Group Education Center 224-D Cornwall St. NW, Suite 401, Leesburg, VA 20176 Telephone 571.209.1850 Fax 703.443.1265 Attention: Angie Bentley Email: Learn@lmgdoctors.com 2015 CPR ENROLLMENT FORM Date: Student Name: LMG Practice Name (if applicable): Program Choices: BLS $90 Heart Savers CPR & First Aid $70 Program Date: February 7 March 21 May 2 June 13 July 25 September 5 October 17 November 28 Payment: Amount Paid $ Cash Check Credit (see below) Credit: Amount to Charge Card: MasterCard [ ] VISA [ ] DISCOVER [ ] AM. EX [ ] Card Number: Expiration Date: Security Code Card Holder Name Address City, State, & Zip Signature: Accepted by: Total: $

Loudoun Medical Group Education Center 224-D Cornwall St. NW, Suite 401, Leesburg, VA 20176 Telephone 571.209.1850 Fax 703.443.1265 Attention: Angie Bentley Email: Learn@lmgdoctors.com NATIONAL TESTING ENROLLMENT FORM Student Name: Address: Cell Phone Number: Email Address: LMG Employee: Yes No If Yes, Practice Name: National Test Type: Medical Assistant Phlebotomy Billing/Coding National Testing & Workshop Dates: January 24, 31 February 21, 28 March 28, April 4 May 23, 30 June 20, 27 July 25, August 1 September 26, October 3 Community & Non-LMG Employee - Total Program Including Workshop, Testing & Workbook $500 $500 Cash Check Credit Card THIS SECTION IS FOR CURRENT LMG EMPLOYEES ONLY Current LMG Employee - Total Program Including Workshop, Testing & Workbook $500 $500 Cash Check Credit Card Payroll deduction (see below) LMG Employee Payroll Deduction Options $50 Per Pay Period (10 paychecks for a total of $500) $100 Per Pay Period (5 paychecks for a total of $500) If an LMG practice paying for any portion of your training as your employer, please specify amount? Yes $ Signature of Approving Manager or Physician: I consent to the above payroll deductions to begin on my next pay period. If my employment at Loudoun Medical Group is terminated or I resign prior to paying off the above amount, I am aware that the remaining balance will be deducted from my final paycheck. Employee Signature: Date: Print Employee Name: CREDIT CARD INFORMATION Name on card Amount to Charge: Cardholder Mailing Address: Type of card: MC Visa Discover AMEX Card Number Expiration date CV Code How did you hear about the LMG Education Center? Flyer at LMG Practice LMG Website Newspaper Ad Craigslist Payroll Stuffer Other FOR USE BY LMG EDUCATION CENTER ONLY Deposit Received: Date Amount $ Payment Method: Credit Card Processed Check Deposited Cash Deposited Employee Initials Payroll Deduction Approved: Date Amount $ Employee Initials PAID IN FULL DATE Employee Initials