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2026 Fiscal Summit & UDS Training
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2027 FACHC Annual Conference
Events Code of Conduct
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Registration Point of Contact
Please provide the contact information for the person placing the registration order. This ensures invoices and receipts are delivered appropriately.
Name
(Required)
Salutation
Dr/Mr/Mrs/Ms
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First Name
Last Name
Title
(Required)
Email
(Required)
Phone
(Required)
Health Center/Organization
(Required)
SELECT YOUR HEALTH CENTER FROM THIS LIST
FACHC, Inc.
AGAPE COMMUNITY HEALTH CENTER, INC. - 04E01228
AZA HEALTH / RURAL HEALTH CARE, INC. - 040340
BANYAN COMMUNITY HEALTH CENTER, INC. - 04E00479
BOND COMMUNITY HEALTH CENTER, INC. - 048050
BORINQUEN HEALTH CARE CENTER, INC. - 040310
BREVARD HEALTH ALLIANCE, INC. - 0438230
BROWARD COMMUNITY AND FAMILY HEALTH CENTERS, INC. - 0415310
CAMILLUS HEALTH CONCERN, INC. - 042400
CARE RESOURCE COMMUNITY HEALTH CENTERS, INC. - 04E00012
CENTERPLACE HEALTH, INC. - 04E01302
CENTRAL FLORIDA HEALTH CARE, INC. - 040210
CFCE HEALTH - 04E01089
CITRUS HEALTH NETWORK, INC. - 0438180
COMMUNITY HEALTH CENTERS, INC. - 041660
COMMUNITY HEALTH NORTHWEST FLORIDA - 0452890
COMMUNITY HEALTH OF SOUTH FLORIDA, INC. - 040320
DUVAL FAMILY HEALTH CENTER - 0420630
EMPOWER U, INC. - 04E00220
EVARA HEALTH / COMMUNITY HEALTH CENTERS OF PINELLAS, INC. - 049070
FAMILY HEALTH CENTERS OF SW FLORIDA, INC. - 041680
FAMILY HEALTH SOURCE - 0423770
FAU / NCHA COMMUNITY HEALTH CENTER - 04E01428
FLORIDA COMMUNITY HEALTH CENTERS, INC. - 040370
FOUNDCARE INC. - 04E01069
GENESIS COMMUNITY HEALTH, INC. - 04E00471
HEALTHCARE DISTRICT COMMUNITY HEALTH CENTER - 04E00551
HEALTHCARE NETWORK - 041700
HEART OF FLORIDA HEALTH CENTER, INC - 04E00013
IBIS HEALTHCARE - 04E01426
JESSIE TRICE COMMUNITY HEALTH SYSTEM, INC - 040330
LANGLEY HEALTH SERVICES - 040250
MCR HEALTH, INC. - 044310
METRO INCLUSIVE HEALTH - 04E01393
MIAMI BEACH COMMUNITY HEALTH CENTER - 044130
NEIGHBORHOOD MEDICAL CENTER INC. - 04E00336
NEW RIVER HEALTH CENTER - 04E00464
NORTH FLORIDA MEDICAL CENTERS, INC. - 040380
ORANGE BLOSSOM FAMILY HEALTH - 0413580
OSCEOLA COMMUNITY HEALTH SERVICES - 04E01256
PALMS MEDICAL GROUP - 042710
PANCARE OF FLORIDA, INC. - 0442450
PINELLAS HEALTH & HUMAN SERVICES - 042040
PREMIER COMMUNITY HEALTHCARE GROUP, INC. - 045500
RURAL HEALTH NETWORK OF MONROE COUNTY FLORIDA, INC. - 04E00517
SMA HEALTHCARE - 04E01461
SUNCOAST COMMUNITY HEALTH CENTERS, INC. - 041750
TAMPA FAMILY HEALTH CENTERS, INC. - 0412810
TREASURE COAST COMMUNITY HEALTH, INC. - 0413190
TRUE HEALTH / CENTRAL FLORIDA FAMILY HEALTH CENTER, INC. - 041720
WALTON COUNTY HEALTH CENTER - 04E00465
WHOLE FAMILY HEALTH CENTER - 04E01274
BIG BEND HOSPICE
OTHER ORGANIZATION
Other Health Center/Organization
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Registration Options
Please complete all fields for the Attendee(s) you are registering.
How many attendees do you need to register?
(Required)
Please enter a number from
1
to
5
.
You may register up to five (5) Attendees at one time.
Attendee # 1 Name
(Required)
Salutation
Dr/Mr/Mrs/Ms/Miss
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
First Name
Last Name
Attendee #1 Ticket Type: (Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $500
Single-Day, In-Person Registration (11/6 - UDS Only) - $475
Single Day, Virtual UDS ONLY Registration (11/6) - $475
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $785
Attendee #1 Ticket Type: (Non-Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $650
Single-Day, In-Person Registration (11/6 - UDS Only) - $600
Single Day, Virtual UDS ONLY Registration (Friday, 11/6) - $600
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $925
Attendee #1: Which Day 1 Track are you planning to attend?
(Required)
Billing & Coding
Fiscal Operations
Both, Billing & Coding and Fiscal Operations
Attendee #1 Title
(Required)
Attendee #1: Years at current Health Center?
(Required)
Please enter a number from
0
to
50
.
Attendee #1 Email
(Required)
Attendee #1 Phone
(Required)
Attendee #1 Dietary Restrictions?
(Required)
If no dietary restrictions, please type NONE or NA.
Attendee # 2 Name
(Required)
Salutation
Dr/Mr/Mrs/Ms/Miss
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
First Name
Last Name
Attendee #2 Ticket Type: (Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $500
Single-Day, In-Person Registration (11/6 - UDS Only) - $475
Single Day, Virtual UDS ONLY Registration (11/6) - $475
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $785
Attendee #2 Ticket Type: (Non-Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $650
Single-Day, In-Person Registration (11/6 - UDS Only) - $600
Single Day, Virtual UDS ONLY Registration (Friday, 11/6) - $600
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $925
Attendee #2: Which Day 1 Track are you planning to attend?
(Required)
Billing & Coding
Fiscal Operations
Both, Billing & Coding and Fiscal Operations
Attendee #2 Title
(Required)
Attendee #2: Years at current Health Center?
(Required)
Please enter a number from
0
to
50
.
Attendee #2 Email
(Required)
Attendee #2 Phone
(Required)
Attendee #2 Dietary Restrictions?
(Required)
If no dietary restrictions, please type NONE or NA.
Attendee # 3 Name
(Required)
Salutation
Dr/Mr/Mrs/Ms/Miss
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
First Name
Last Name
Attendee #3 Ticket Type: (Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $500
Single-Day, In-Person Registration (11/6 - UDS Only) - $475
Single Day, Virtual UDS ONLY Registration (11/6) - $475
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $785
Attendee #3 Ticket Type: (Non-Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $650
Single-Day, In-Person Registration (11/6 - UDS Only) - $600
Single Day, Virtual UDS ONLY Registration (Friday, 11/6) - $600
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $925
Attendee #3: Which Day 1 Track are you planning to attend?
(Required)
Billing & Coding
Fiscal Operations
Both, Billing & Coding and Fiscal Operations
Attendee #3 Title
(Required)
Attendee #3: Years at current Health Center?
(Required)
Please enter a number from
0
to
50
.
Attendee #3 Email
(Required)
Attendee #3 Phone
(Required)
Attendee #3 Dietary Restrictions?
(Required)
If no dietary restrictions, please type NONE or NA.
Attendee # 4 Name
(Required)
Salutation
Dr/Mr/Mrs/Ms/Miss
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
First Name
Last Name
Attendee #4 Ticket Type: (Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $500
Single-Day, In-Person Registration (11/6 - UDS Only) - $475
Single Day, Virtual UDS ONLY Registration (11/6) - $475
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $785
Attendee #4 Ticket Type: (Non-Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $650
Single-Day, In-Person Registration (11/6 - UDS Only) - $600
Single Day, Virtual UDS ONLY Registration (Friday, 11/6) - $600
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $925
Attendee #4: Which Day 1 Track are you planning to attend?
(Required)
Billing & Coding
Fiscal Operations
Both, Billing & Coding and Fiscal Operations
Attendee #4 Title
(Required)
Attendee #4: Years at current Health Center?
(Required)
Please enter a number from
0
to
50
.
Attendee #4 Email
(Required)
Attendee #4 Phone
(Required)
Attendee #4 Dietary Restrictions?
(Required)
If no dietary restrictions, please type NONE or NA.
Attendee # 5 Name
(Required)
Salutation
Dr/Mr/Mrs/Ms/Miss
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
First Name
Last Name
Attendee #5 Ticket Type: (Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $500
Single-Day, In-Person Registration (11/6 - UDS Only) - $475
Single Day, Virtual UDS ONLY Registration (11/6) - $475
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $785
Attendee #5 Ticket Type: (Non-Members)
(Required)
Single-Day, In-Person Registration (11/5 - Fiscal Summit Only) - $650
Single-Day, In-Person Registration (11/6 - UDS Only) - $600
Single Day, Virtual UDS ONLY Registration (Friday, 11/6) - $600
2-Day Combo, In-Person Registration (11/5 Fiscal Summit & 11/6 UDS) - $925
Attendee #5: Which Day 1 Track are you planning to attend?
(Required)
Billing & Coding
Fiscal Operations
Both, Billing & Coding and Fiscal Operations
Attendee #5 Title
(Required)
Attendee #5: Years at current Health Center?
(Required)
Please enter a number from
0
to
50
.
Attendee #5 Email
(Required)
Attendee #5 Phone
(Required)
Attendee #5 Dietary Restrictions?
(Required)
If no dietary restrictions, please type NONE or NA.
Total
Billing
Total
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Coupon codes are not case sensitive.
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MasterCard
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Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
Year
2026
2027
2028
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2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Security Code
Cardholder Name
Billing Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
All requests for refund must be made in writing to Nicole Rechner at nrechner@fachc.org on or before Friday, October 9, 2026. No refunds will be issued after this date. All eligible refund requests will be subject to a $50 administrative fee. Substitutions are welcomed and strongly encouraged.
(Required)
I acknowledge and agree to the above stated refund & substitution policy.
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