CEU Manual Order Form

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Thank you for purchasing manuals from CEU / Consulting & Education Unlimited, LLC! Once the order form and payment is received, you will receive via email a Limited License to Copy for each manual purchased. Please note: If you have multiple communities, a separate order form and additional payment is required. Use of our manuals is for one address only. Please allow 1-3 weeks for delivery of your order depending on digital or printed. Thank you!

Email *

Today's Date *

YYYY

What is the item you would like to order? *

If you are an ACF, would you like the Provider Transition Plan (PTP) documents separated from the Policy & Procedure Manual? This is an additional $100 fee.

Yes

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Name of Community - Please fill out exactly as you would like it to be on the manual. *

Administrator's Name *

Community Phone number *

Community Fax Number *

Community Address: Number & Street Name *

Community Address: City, State, and Zip Code

In what county is the community located?

Community Email *

Will this community be licensed as an ACF (Medicaid) Facility? *

Yes

Will this commuity be licensed as a Secured Environment Facility? *

Yes

If choosing to have manuals printed at an additional cost, please submit the complete shipping address:

The digital files will be shared via Google Drive, and you will need to have a Google Account / Gmail email address to access the files. Please list the Gmail email address you will be using to access the files. *

Preferred contact method *

Phone

Required

Questions and comments

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