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NEEDS ASSESSMENT FOR TRAINING ON THE NEUROPSYCHIATRIC ASPECTS OF HIV/AIDS
100%
Office of HIV Psychiatry, American Psychiatric Association
1000 Wilson Blvd., Suite 1825, Arlington, VA 22209
703-907-8668
www.psych.org/aids
<mailto:aids@psych.org>aids@psych.org</mailto>
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1.
My contact information:
(Required.)
First Name
Last Name
Degree
Title/Position
Affiliation
Street Address
City
State
Zip
Telephone
Fax
E-mail
*
2.
Indicate topics of interest:
(Required.)
Neuropsychiatric Overview (CNS/PNS complications)
Mood disorders (includes major depression, bipolar disorders, and suicidality)
Anxiety disorders
Sleep disorders and insomnia
Pain syndromes
Triple Diagnosis HIV/Substance Use/Mental Illness
Neurocognitive screening
Drug-drug Interactions and Toxicity
Other (please specify)
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3.
Indicate specific population groups of interest:
(Check all that apply.)
(Required.)
LGBT
Children/adolescents
Women
African Americans
Hispanics
Native Americans
Asian/Pacific Islanders
Substance users
Severely, chronically mentally ill
Rural populations
Other (please specify)
4.
Indicate the anticipated audience size:
25-50
50-75
75-100
More than 100
5.
Indicate the meeting/program type:
Grand rounds
Resident lecture
Resident case discussion
Webinars
Lecture
Interactive workshop
Issue-specific conference
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6.
Proposed training location:
(Required.)
*
7.
Preferred timeframe (ex. Noon - 3 pm):
(Required.)
*
8.
Dates and times available:
We will work to accommodate your preferred training date pending faculty availability.
(Required.)
Option 1:
Option 2:
Option 3:
Option 4:
9.
Comments/questions:
*Please note:
Training modules and other HIV psychiatry resources and materials are available to download for free at
www.psych.org/aids
.