Register Please complete the form below. You will then be redirected to pay. Your registration is not complete without payment. Name * First Name Last Name Email * Phone * (###) ### #### Profession * Degree/License Number * Have you been in practice for at least 2 years? * Individuals must be licensed for 2 years to take this course if intending to apply to become a supervisor. LPCs or LMFTs who have been in practice for a minimum of 1 year may enroll in this course as an informational class. I have been a licensed clinician for 2+ years I have been licensed for at least 1 year but not yet 2 years What is the name of your practice or organization? * What category does your organization fall into? * Agency Private practice (solo) Private practice (group) Hospital or medical Church or parachurch ministry Educational Non-profit other than counseling How did you hear about this training? If you found it through social media, which platform or group? Have you ever attended a training at The Center or Restore Behavioral Health? This is my first! I can't get enough! Are you an employee at Restore? Yes No If yes, will you be using your free CEUs for this course? Yes No See you at The Center!
