Maximizing Client Assessment for Effective Case Management
Complete the form below to register for "Maximizing Client Assessment for Effective Case Management" on Wednesday, March 14, 2018. This training will take place from 9:30 am - 12:30 pm at Community Health Center, 675 Main St, Middletown, CT.

PLEASE NOTE: All sessions are free for ACT members. Non-members will be charged $25 per person (please mail check to ACT, 110 Bartholomew Ave, Ste 3050, Hartford, CT 06106). Failure to attend without a phone call/email at least 24 hours in advance will result in a $25 no-show charge and may limit your access to future trainings.

Case Manager Type *
What type of Case Manager are you?
Previous Trainings *
Have you attended any previous CMTI training sessions?
Agency Category *
Please select the category that best describes the agency you are employed by:
First Name *
Your answer
Last Name *
Your answer
Agency *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email *
Your answer
Phone *
Your answer
Supervisor Name *
Please list your supervisor's name.
Your answer
Supervisor Email *
Please list your supervisor's email address.
Your answer
Supervisor Phone *
Please list your supervisor's phone number (with extension, if applicable).
Your answer
No-Show Policy Acknowledgment *
A cancellation of a scheduled instructor-led training made less than twenty-four (24) hours prior to the day of the scheduled training will be deemed a "no-show". No-shows for all confirmed registrations will be assessed a $25 "no-show" fee. In addition, recurring "no-shows" may have their access to future trainings restricted.
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms