Harm Reduction Psychotherapy Training Group Application Form
Please complete this form and the required questions. Currently, we are planning on offering this supervision group in-person from 12:15 to 1:45 p.m. once a month on Fridays, beginning 9/29. Meetings will be held at The Center for Optimal Living (370 Lexington Avenue, suite 500, New York, NY 10017). We are open to adjusting the time to accommodate the participants.

If you have any questions, please email Dr. Jenifer Talley at jtalley@cfol.org or call 212.213.8905 x106.

Email address
Name
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Address and Phone Number
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How did you hear about this program?
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Have you completed the 3-day IHRP Training and/or Harm Reduction Psychotherapy Certificate Program? If so, please specify.
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Professional Qualifications: Please list highest degree obtained, school, and date of completion.
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Current employment
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Areas of specialization and advanced training (if applicable).
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If you are interested but unable to join us on Fridays 12:15 to 1:45 p.m., please suggest an alternative day/time that would work for you.
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Please provide your name and current date as confirmation that the information above is valid and accurate.
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