BLI Information & Process Form Effective January 1, 2023, BLI pricing will be as follows (price includes travel): 30-60 minute sessions: $325 + $50 (admin fee) = $37590 minute sessions: $400 + $50 (admin fee) = $450Virtual sessions: $325 + $25 (admin fee) = $350Health Fairs: $75 per hour, plus travel (currently no admin fee) Date submitting this form:(Required) MM slash DD slash YYYY Client:(Required)Account Rep:(Required)Use of BLI approved by:(Required)Choose oneAngela DelahuntKaren KeisPatty ReardonName of Training:(Required)Date/s of Training:(Required)BLI cost as quoted to Acct Rep:(Required)Is the cost covered under the contract?(Required) Yes No Cost quoted to Client if client is paying (Cost per training):(Required)Contact name for Invoice to be sent to:(Required)Contact’s Email Address: Additional Comments
