Registration for Ethics in the Digital Age, Sept 6, 2013

3 ethics CEUs approved for LADC, CADC, Case Manager, LPC and LMFT.

Go to www.EnvisionOK.com for more information about all our trainings and our Associate Membership Program.

Question Title

1. Please complete the following for the training participant:

Name: *

Company: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Associate Member Number:

Email Address: *

Phone Number: *

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2. Is someone other than the individual listed above is paying for this registration? if so, please complete this section.

Billing Name:

Billing Company:

Billing Address:

Billing Address 2:

Billing City/Town:

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3. Credentials (select all that apply):

LADC

CADC

LPC

LMFT

Case Manager

LCSW

Supervisor

Under Supervision/Candidate

Other (please specify)

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4. Please select your payment amount below:

Free: Associate Membership Program (go to www.EnvisionOK.com for details)

$75 = Full Registration

$67.50 = Early registration discount if registering 7 days prior to training

$71.25 = Individual loyalty discount if registering for 2nd training within 12 months or when registering for 2 or more on the same day.

$71.25/person = Group Discount for 2 or more attendees from the same office

Please list those attending from your office:

Question Title

5. Payment method:
Total participant size is limited to 12. No refunds unless cancelled 48 hours prior to training. Please understand because our participant size is small everyone is important. Your seat is reserved when payment is received.

I will go to wwwEnvisionOK.com and pay using PayPal or a credit card.

Please send an invoice to my email so I can pay using PayPal or Credit Card

I will mail you a Check/money order

To pay by check or money order, send payment to:
Envision Counseling Associates
P.O. Box 1762
Norman, OK 73070

If you select payment by credit card or Paypal you will receive an email invoice with payment instructions.

Thank you for your registration. Upon receipt of your payment you will receive a payment receipt which is your registration confirmation. Call Gail at 405-698-1762 or email register@envisioncounselingok.com if you have any questions.

Training description:

Over the past several decades, technology has advanced at an amazing rate. As new technology develops, professionals are challenged to define appropriate ethical boundaries to accommodate the technology while protecting clients rights. Some Counselors are contemplating using technologies such as Facebook, twitter, cell phones, email, and Skype to expand or enhance their practice.

Schedule and Objectives:

1:15 p.m. – 1:30 p.m. Registration
1:30 p.m. – 4:30 p.m.

- Brief review of some of the technologies currently available and used by some therapist.

- Review of a Ethical Framework of any counseling environment

- Identify and discuss practical strategies for evaluating what technologies if any to incorporate into your practice.

- Participants will use case examples to identify challenges, benefits, concerns and potential solutions related to incorporating common technology into a counseling practice.

Trainers: Gail Wilcox, LADC, LPC,

Training location: 1005 N Flood St, Suite 137, Norman, OK 73071

PLEASE PRINT A COPY OF THIS PAGE FOR YOUR RECORDS

Directions to our office:
From I-35:
Take Robinson Street exit and go East to Flood Avenue. Turn right (south) on to Flood Avenue. After you pass Daylight Donuts (on the right) you should see a sign for Elite Plaza on the left. Turn left into the parking lot just past The Elite Plaza sign. Directly in front of you is "A Cut From Above." Turn left between the two buildings. We are in the building on the right (east). You should see a set of double glass doors set back (not flush with the front of the building) go through those doors and turn right.

From the East on Highway 9:
Turn north on 24th street East and follow the road until you get to Robinson Street and go West (left) to Flood Avenue. Turn left (north) on to Flood Avenue. After you pass Daylight Donuts (on the right) you should see a sign for Elite Plaza on the left. Turn left into the parking lot just past The Elite Plaza sign. Directly in front of you is "A Cut From Above." Turn left between the two buildings. We are in the building on the right (east). You should see a set of double glass doors set back (not flush with the front of the building) go through those doors and turn right.

From The west on Highway 9:
Turn north (left) on 24th street west. Turn right (east) onto Robinson Street and go East to Flood Avenue. Turn right (south) on to Flood Avenue. After you pass Daylight Donuts (on the right) you should see a sign for Elite Plaza on the left. Turn left into the parking lot just past The Elite Plaza sign. Directly in front of you is "A Cut From Above." Turn left between the two buildings. We are in the building on the right (east). You should see a set of double glass doors set back (not flush with the front of the building) go through those doors and turn right.

We are looking forward to seeing you at the training. The directions above may not match directions suggested by your GPS and may not be the fastest. I think they are the simplest.

Call Gail at 405-498-1762 if you need additional assistance.

Question Title

6. For Envision Counseling Associates Only:

Invoice sent:

Date

Receipt sent:

Date

Question Title

1. Please complete the following for the training participant:

Question Title

2. Is someone other than the individual listed above is paying for this registration? if so, please complete this section.

Question Title

3. Credentials (select all that apply):

Question Title

4. Please select your payment amount below:

Question Title

5. Payment method: Total participant size is limited to 12. No refunds unless cancelled 48 hours prior to training. Please understand because our participant size is small everyone is important. Your seat is reserved when payment is received.

Question Title

6. For Envision Counseling Associates Only:

5. Payment method:
Total participant size is limited to 12. No refunds unless cancelled 48 hours prior to training. Please understand because our participant size is small everyone is important. Your seat is reserved when payment is received.