Cognitive Behavioral Therapy (CBT) for Substance Use Disorders (SUDs) Registration - R9.1.1

Name*

First Last

Credentials*

Agency/Organization*

Current Position*

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Work Phone Number

Cell Phone Number*

(NFARtec Staff will be sending weekly SMS text messages related to course content. By inputting your phone number, you consent to receive text messages sent through an automatic telephone dialing system.)

Email*

Enter Email Confirm Email

Password*

Enter Password Confirm Password

Strength indicator

Type of Continuing Education Requested (check all that apply)*

License/Certification Number (Required for ISAP’s PSY/RN approvals)*

Languages Spoken Fluently*

Are you currently providing treatment and/or recovery services in the behavioral health field?*

Yes
No

Do you have a background in or have you attended Cognitive Behavioral Therapy (CBT) training for use in clinical practice?*

Yes
No

If yes, please explain*

What do you hope to learn by taking the CBT series?*

How did you learn about this event?*

By checking here you are indicating that you understand the expectations and technology requirements as well as the time commitment to participate in this training.*

I understand the time commitment involved and agree to fully participate.