safeTALK Training Registration
Carson City Sheriff's Office
May 14th, 2021
1:00 - 4:00 PM

Question Title

* 1. Please enter the information requested below

Last Name *

First Name *

Nick Name *

Job Title

Agency

Zip Code *

Email Address *

Phone Number *

Question Title

* 2. safeTALK has been approved for Continuing Education Units by the Dept. of Education, POST, Pharmacy, Physical Therapy, Psychological Examiners, Social Workers, and SNHD. Nurses, CPC/MFTs, ADGCs may apply Social Workers CEUs toward their license requirements.

If you need Continuing Education Units for attending this course, please enter the information below. Failure to enter the information below may delay your CEU certificate.

Licensing Agency/Discipline

License number

Question Title

* 3. Please agree to notify us as soon as possible if you need to cancel registration for this class. We have a maximum number of attendees per class and would like to ensure no seat goes unfilled. These classes are important to the safety of our community members and as such are highly sought after by community members and professionals. We do understand some things are unavoidable like illness or emergency. In an attempt to fill all available seats please email jmassolo@health.nv.gov for the Reno Office (north) or regan@health.nv.gov for the Las Vegas Office South as soon as you are aware that you cannot attend, Thank You

Yes

No