Application for Weekend Auricular Acu-Tech Training in Providence, October 9+10, 2021
Once we review your application information we will send you a link to our registration page where you can pay or we will contact you with follow-up questions.

Cost for training is sliding scale r $200 to $325 but does not include POCA membership dues. Active POCA membership is a requirement for completing this course. POCA memberships are $25. Join via POCA's website (https://pocacoop.com/join) A POCA membership offers AATs access to licensed acupuncturists, which fulfills the general supervision requirement in the new law.


Completing this application is NOT a guarantee of registration.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Pronoun(s) you use *
Phone Number *
Address *
City *
State *
Zip Code *
Are you a current POCA member? *
Captionless Image
Occupation and/or organizational affiliation *
Tell us briefly why you are interested in attending an AAT training and/or how you plan to implement the 5NP in your work or community. *
How did you hear about this training? *
Anything else we should know for you to be able to participate in this training?
The recent law that passed in RI allows people with the following licenses and certifications to legally practice 5NP. All are welcome in our training, but we will be giving priority to people who will be able to practice in their work and spread access to this tool. If you are interested but do not have any of these licenses or certifications, please still fill out this application and we will invite you to the training as space allows. Do you have any of the following certifications or licenses in Rhode Island? (check any that apply) *
Required
If you checked any of the boxes above please include your the number for your Rhode Island professional licenses and/or certifications (e.g. LISCW 03883, or LMHC 1234)
Will you be able to attend at least 2 of the required practice sessions following the weekend training? These will be held on either Friday evenings or Saturdays (approximately 3 hours long) in the weeks following the training. *
For Peer Recovery Specialists: Would you like information about tuition support for this training?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy