9th Annual Centers of Excellence Conference Registration

9th Annual Massachusetts Department of Mental Health’s

Research Centers of Excellence Conference

“Targeted Community Outreach and its Impact on Service Engagement”

March 16, 2017 8 am –1 pm
(8:00 – 9:00 Registration)
Massachusetts Mental Health Center
75 Fenwood Road, Room 211, Boston MA

Please register each person from your organization separately. Due to space limitations we will be unable to allow walk-in registration.
An email confirmation will be sent after the registration deadline (March 10, 2017).

Question Title

* 1. CONTACT INFORMATION

First Name:

Last Name:

Job Title:

Agency / Organization:

Email Address:

Phone Number:

Question Title

* 2. Continuing Education Credits have been requested for Social Work, Nursing, Psychology, OT and LMHC. (Approval is still pending.) Please select from the following disciplines if you would like to request CE's for this training:

Social Work

LMHC

Nursing

Psychology

2nd Discipline if requesting more than one.

Question Title

* 3. Do you need a special accommodation (i.e. ASL interpreters) to fully participate in this conference? If yes, please specify in the box below.

Yes

Please Specify:

If you have any questions please email bobbi.spofford@massmail.state.ma.us.