Opioid Impacted Family Support Training Program (OIFSP) Certified Recovery Peer Specialist and/or Certified Recovery Support Specialist Application

Training Year: 2021 - 2024

PLEASE READ CAREFULLY:

Allow yourself at least 45-minutes to an hour to complete this application in its entirety. Please do not submit more than one application.

Step 1: Complete the entire application, Incomplete Applications will be deleted. After submitting your application, you will be directed to schedule an application review with the program specialist.

Step 2: The program Specialist will be able to answer any questions you have and provide you with more information about the program. After your application review, she will forward your application to the training team who will determine if your application is in line with the goals of the program.

Step 3: You must complete an interview with the program coordinator and program specialist. After your application is approved and you are accepted into the program, you will receive an email stating as such along with the most current schedule all required program forms.

Contact information: peer.network@lsfnet.org org

Project Description and Goal: LSF Health Systems (LSF) is partnering with provider agencies in Northeast Florida to expand the number of peer support specialists working in integrated, inter-professional teams providing services to children whose parents are impacted by opioid use disorders (OUD) and other substance use disorders (SUD). The training program will offer two paraprofessional certificate tracks: 1) the Certified Recovery Peer Specialist (CRPS) certificate; and 2) the Certified Recovery Support Specialist (CRSS) track.

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* 1. Applicant Information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Primary Email Address

Primary Phone Number

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* 2. Select the certificate track you are interested in applying for.

The CRPS credential is for people who use their lived experience and skills learned in training to help others achieve and maintain recovery and wellness from mental health and/or substance use conditions.

The CRSS credential is for people who work side-by-side with clinical staff to provide recovery support services to individuals with substance use conditions. CRSS applicants may or may not have lived experience as a person in recovery.

CRPS Only (Adult, Family, Veteran, and/or Youth)

CRSS Only

Both, CRPS and CRSS

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* 3. Please mark all that apply:

I am currently employed in a peer specialist position.

I am currently volunteering in a peer specialist position.

I have an offer of employment pending successful completion of my 40 hour training.

I have demonstrated leadership and support experience related to mental health and/or substance use conditions.

None of the above

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* 4. If currently employed or volunteering, please provide the following information

Name of agency or organization:

Address of agency or organization including zip code:

Supervisor Name:

Supervisor Email and Phone Number:

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* 5. The Florida Certification Board requires 500 documented hours of volunteer/work experience as a Recovery Peer Specialist (RPS) prior to taking the CRPS certification exam. Which of the following best describes the amount of documented hours you have?

I do not have any documented experience hours

I have less than 250 documented experience hours

I have between 250-499 documented experience hours

I have 500 or more documented experience hours

I am not applying for CRPS

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* 6. The Florida Certification Board requires 1,000 documented hours of volunteer/work experience as a Recovery Support Specialist (RSS) prior to taking the CRSS certification exam. Which of the following best describes the amount of documented hours you have?

I do not have any documented experience hours

I have less than 250 documented experience hours

I have between 250-499 documented experience hours

I have 500 or more documented experience hours

I am not applying for CRSS

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* 7. Are you a veteran?

Yes

If yes, are you prior service or retired?

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* 8. Do you live in rural community or county?

Yes

Not sure

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* 9. Do you have access to a computer?

Yes

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* 1. Applicant Information

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* 3. Please mark all that apply:

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* 4. If currently employed or volunteering, please provide the following information

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* 5. The Florida Certification Board requires 500 documented hours of volunteer/work experience as a Recovery Peer Specialist (RPS) prior to taking the CRPS certification exam. Which of the following best describes the amount of documented hours you have?

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* 6. The Florida Certification Board requires 1,000 documented hours of volunteer/work experience as a Recovery Support Specialist (RSS) prior to taking the CRSS certification exam. Which of the following best describes the amount of documented hours you have?

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* 7. Are you a veteran?

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* 8. Do you live in rural community or county?

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* 9. Do you have access to a co﻿mputer?

* 9. Do you have access to a computer?