Harm Reduction Psychotherapy Training Group Application Form
Please complete this form and the required questions. This supervision group meets in-person from 12:15 to 1:45 p.m. once a month on Fridays, beginning December 15, 2017. Meetings will be held at The Center for Optimal Living (370 Lexington Avenue, suite 500, New York, NY 10017). Investment: $700.

If you have any questions, please email info@cfol.org or call 212.213.8905 x2.

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? Or will you attend the 3-day training December 1-3, 2017? 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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Please provide your name and current date as confirmation that the information above is valid and accurate. *
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