Empowering Response: Advancing Crisis Intervention & Suicide Prevention Strategies in Trauma-Informed Care Systems Registration R3.2.1

Name*

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Credentials*

Agency/Organization*

Job Title/Current Position*

Mailing Address*

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

Email*

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Password*

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Mobile 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. If you no longer want to receive the text, please reply STOP once the messages are sent.)

How did you learn about this event?*

Are you Hispanic or Latino/a?*

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What is your race?*

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Do you hold a supervisory role in your current position?*

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No

If yes, you may be contacted via email by an external evaluation team to gather feedback about ways the Central East ATTC can help support your organization’s mission through advancing the substance use treatment workforce.*

Yes
No

By checking here you are indicating that you understand the pre-requisite 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.