Registration for Polyvagal-based Interventions for Trauma Prevention and Resolution in First Responders

Please register for the upcoming Polyvagal-based Interventions for Trauma Prevention and Resolution in First Responders training.

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Preferred Email

Question Title

* 4. Individuals who are masters-level mental health practitioners or are graduate students in mental health professions are welcome to attend. What are your credentials?

Question Title

* 5. Employer

Question Title

* 6. Work Address

Question Title

* 7. The session you plan to attend is

May 18 -19: Coeur d'Alene, ID - Station #2 3850 Ramsey Road

June 13-14: Twin Falls, ID - CANCELLED. Please join the training session in Idaho Falls.

June 23-24: Idaho Falls, ID - Station #1 343 E. Street

June 29-30: Nampa, ID - Nampa Fire Dept 300 W. Railroad Street

September 21-22: Boise City Hall West, Sawtooth Auditorium, 333 N Mark Stall Pl. Boise, ID

Question Title

* 8. Will you need CEUs?

Yes

Other (please specify)

Question Title

* 9. Do you understand the following required training times to receive CEUs?
Day 1: 8am-5pm
Day 2: 8am-12pm, 12-1:30pm meet with local first responders

Yes

Other (please specify)

Question Title

* 10. Which of the the following do you work with? Check all that apply

Dispatchers

Firefighters

Paramedics

EMT

Law Enforcement

Youth

Other (please specify)

Question Title

* 11. How many first responder and/or youth clients do you see monthly?

1-9 first responder and/or youth clients

9-20 first responder and/or youth clients

21-30 first responder and/or youth clients

31+ first responder and/or youth clients

Other (please specify)

Registration for Polyvagal-based Interventions for Trauma Prevention and Resolution in First Responders

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Preferred Email

Question Title

* 4. Individuals who are masters-level mental health practitioners or are graduate students in mental health professions are welcome to attend. What are your credentials?

Question Title

* 5. Employer

Question Title

* 6. Work Address

Question Title

* 7. The session you plan to attend is

Question Title

* 8. Will you need CEUs?

Question Title

* 9. Do you understand the following required training times to receive CEUs?Day 1: 8am-5pmDay 2: 8am-12pm, 12-1:30pm meet with local first responders

Question Title

* 10. Which of the the following do you work with? Check all that apply

Question Title

* 11. How many first responder and/or youth clients do you see monthly?

Question Title

* 12. What are you looking forward to the most during this training?

* 9. Do you understand the following required training times to receive CEUs?
Day 1: 8am-5pm
Day 2: 8am-12pm, 12-1:30pm meet with local first responders