Qualtrics Survey | Qualtrics Experience Management

Name

Job Title/Position

Agency

Email

Address

Phone

Tribal Enrollment

Name of Supervisor

Supervisor Email

Supervisor Phone

What type of license do you hold?

If you are not licensed, when do you anticipate becoming licensed?

TF-CBT treatment protocol rquires weekly regular sessions with children and care givers. Please explain your agencies system for weekly therapy sessions.

All items below are required to attend training. Once the training dates have been set, you will receieve a link to register. Please select all items that have already been completed or will be completed prior to training.

Completed Registration Form
Current Resume/CV
Certificate of online training- https://tfcbt2.musc.edu/
Registration Fee $4,000 per trainee