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Agency Training Contact Form
Thank you for completing my questionnaire. Please respond to all questions and elaborate in the spaces provided as needed.
Please note there is a final step to schedule a discovery call after you submit your answers.
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Email Address
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Your answer
Phone Number
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Your answer
Organization Name
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Your answer
Contact Name
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Your answer
Location of Organization
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Your answer
Proposed training month/year, if known. (If training needs to be provided before or after a certain date for budget reasons, please indicate):
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Your answer
Proposed Topic
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CBT for Early Psychosis
Group CBTp
CBTp for Clinical High Risk
Advanced CBTp
Fundamentals Behind CBT for psychosis, on-demand course, organization pricing
3 Steps to Transform your Interactions with Patients with Psychosis (for Nursing staff)
Other:
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Why are you seeking training at this time?
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Your answer
What are the specific objectives you'd like to see accomplished? Be as specific as you can.
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Your answer
How many hours of workshop training were you anticipating prior to contacting us?
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Your answer
How many people were you hoping to attend the training?
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Your answer
Please describe the degree/certification levels of your staff.
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Your answer
Did you anticipate including any follow-up case-consultation when you thought about pursuing this training?
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Yes
No
If "yes" to the above question, how many hours had you budgeted for?
Your answer
How did you hear about me?
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Your answer
Anything else we need to know?
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