Adult Behavioral Health in Primary Care Registration

Adult Behavioral Health in Primary Care
Registration Form

Please use the form below to register for an upcoming Adult Behavioral Health in Primary Care course, where you will learn to:

1. Correctly identify and differentiate among behavioral health problems such as anxiety and somatic symptoms, depression, chronic pain, substance abuse, adult ADHD, psychosis, and bipolar disorder.

2. Effectively manage psychopharmacology: select medications, initiate and taper dosages, monitor improvements, and identify and minimize medication side effects.

3. Create and implement a treatment plan by mobilizing existing resources.

Duration: Three-day live course, followed by eight (1-hour) group learning calls

Format: Virtual

Cost: $1900

If the dates listed do not work for your schedule, please sign up to be notified of future training courses here.

This form is intended for registration of single participants. To register a group of participants, please email us at [email protected]

Program Information

Program

Please select the start and end dates of your chosen program.

Start Date

End Date

Contact Information

Salutation

First Name

Last Name

Participant Email

The participant's email address must be entered for registration. All program communications prior to, during, and after the program require responses from the participant directly.

Receive REACH monthly newsletter

Opt In

Phone

Please provide your mailing address below. Mailing address is required in order to receive program materials.

Mailing Country

Mailing Street Address

Mailing State/Province

Mailing City

Mailing Zip/Postal Code

Professional Information

With which license do you practice?

List other/additional licenses

What is your discipline?

List other/additional discipline

What is your occupation?

Organization/Practice Name

Organization/Practice Country

Organization/Practice Street Address

Organization/Practice City

Organization/Practice State/Province

Organization/Practice Zip/Postal Code

Referral Information

How did you hear about REACH?

Please select social media platform, if applicable

If referred, please specify who referred you:

Referred by (First Name):

Referred by (Last Name):

REACH does not sell or share any personal registration data.

Payment Information

Payment Amount

Name on Card

Card Number

Code

Billing Email

Billing Country

Billing Street Address

Billing State/Province

Billing City

Billing Zip/Postal Code

Contact Information

Adult Behavioral Health in Primary Care Registration

Adult Behavioral Health in Primary Care Registration