Helping Families Reduce Health Risks & Promote Well-Being for LGBTQ Children & Youth

The County of Santa Clara Behavioral Health Services Department and Office of LGBTQ Affairs are proud to welcome Dr. Caitlin Ryan and the Family Acceptance Project to our community for this much awaited training opportunity! Please complete this Registration Form to lock in your space today!

*Please register at least 2 days prior to the training to ensure you receive the training information

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* 1. What date training will you be attending?

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* 2. What is your name? 

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* 3. What is your email address?

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* 4. We would like to mail you hard copies of the training materials. Please provide your address if you're okay with receiving the materials by mail.

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* 5. What is your role in the context of this training?

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* 6. What is the name of the Agency and/or Department you work for?

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* 7. What is the name of the Program you work for?

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* 8. What is your primary practice setting? (please choose the best match)

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* 9. What is your contact phone number?

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* 10. What is the primary population you work with? 

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* 11. This training offers CEs - will you be requesting CEs?

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