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What is your education level?

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High School Graduate Year Graduated:                

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Why are you interested in the medical field?

What programs are you interested in?

Medical Assistant-

Medical Office Assistant-

Patient Care Assistant-

All Programs-

How soon are you planning to start your training?

  I'm Ready to Start Now!   Next month   Just Started Planning not sure

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Any Other Comments Questions

Have you ever enrolled or attended PCI? NO  YES