Registration: Motivational Interviewing Groups: Moving Together Toward Change

Name*

First Last

Credentials

Agency/Organization*

Current Position*

Addiction Counselors
Nurse Practitioners
Nurse
Peer Recovery Support Positions
Physician
Physician Assistants
Prevention
Social Workers

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Email*

(By providing your email address, you will automatically be added to the Mountain Plains ATTC listserv; to opt-out, please contact a MPATTC Staff Member at workwise@casat.org)

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Password*

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

Yes
No

Do you have experience facilitating groups?*

Yes
No

Do you have a background in or have you attended Motivational Interviewing training for use in clinical practice?*

Yes
No

If yes, please explain*

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

Tour of MI Certificate of Completion*

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Max. file size: 64 MB.

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.

PLEASE READ PRIOR TO COMPLETING THIS REGISTRATION