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CONSULTATION REQUEST
About
Provider
Registration
Consultation
Education
Resources
Family
Resources
Contact
Consultation Request
Free Training!
Free Training!
Rakel Haas
2025-04-30T20:31:33-05:00
SPARK/OKCAPMAP House Calls Training Request
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Name
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First
Last
Email
(Required)
Enter Email
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Training Location Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Select one or more training topics you are interested in…
(Required)
Anxiety
ADHD
Depression
Trauma/Trauma Informed
Substance Use
Opioid Use
Autism
Cannabis
Infant Mental Health
Dual Diagnosis
Motivational Interviewing
Suicide Prevention
Engaging Families
What time of year were you thinking about hosting our training?
(Required)
Fall 2024
Winter 2024/25
Spring 2025
Summer 2025
What time of day were you thinking about hosting our training? (Please be aware that the training must be for minimum of one hour.)
(Required)
Morning
Noon
Afternoon
Where would you prefer your training conducted?
(Required)
Online only
Hybrid (Online and in Person)
In Person only
How many people do you expect to attend the training? (There must be a minimum of 5 people present at the physical location in person only/hybrid training options. There must be a minimum of 5 people present for the online only training option.)
(Required)
5-10 in person
10-20 in person
20-30 in person
30+ in person
Online only, 5 or more
What kind of certifications will your training attendees carry that are interested in free CME's?
(Required)
LPC/LMFT
LMSW/LCSW
DO
MD
APRN/PA
PsyD
PhD
other
Please list 1-2 possible dates and any additional comments or questions. Please also share an estimate here of attendees if your expecting more than 30 people to attend.
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