This application is a requirement of the DODD and must be provided prior to class.  Completed applications can be emailed to jSchafer@nursingnavigators.org or fax to 330-838-2243.

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Page 2 of the application will be provided and completed in class.

*By signing page one, you confirm that all of the state required checks have been completed, results obtained, and attendee is eligible to take the medication course

1. If you are an Independent Provider you MUST have a DODD provider number.

2. Prior to class the following must be submitted to Jes Schafer at JSchafer@nursingnavigators.org

   • Evidence of High School Diploma or GED

   • A copy of a state Issued ID

   • Page 1 of the DODD application (page 2 of the application will be provided and completed at the start of the class)

Due to limited seating, we request you cancel at least 48 hours before a scheduled class. This gives us the opportunity to fill the class.

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Cancellations will be processed as follows:

1. Cancellations made prior to 24 hours before a scheduled class via email, text or phone call will be processed without a penalty.

2. Cancellations made within 24 hours of a scheduled class will be subject to a charge of half of the class rate.

3. If a provider cancels with less than 24 hours’ notice, a new class will be scheduled, subject to availability, and the provider will be subject to a charge of half the class rate.

4. No shows will be charged half of the class rate and subject to pay prior to attending all future classes.