JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Caregivers Guide Registration
Day/Time: Wednesday's From 5:30pm - 7:00pm
Cost: Free For First 5 Weeks!
Participation is not required at every weekly session to register and attend. If you would like to receive a Certificate of Completion, you will need to attend all five weeks, and CE's will be offered for those interested for the low cost of $30.00!
Delivery:
A Zoom link will be provided after registration. The same link will be used for each weekly group, and you will be sent a calendar invitation to the email you provided with the Zoom link attached.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name of each person registering and attending
(Each participant must register to receive a Certificate of Completion).
*
Your answer
Please indicate which 5-Week Group you are registering for:
*
October 1 - October 29th
Primary email address
*
Your answer
Your New Mexico County
*
Choose
Bernalillo
Catron
Chaves
Cibola
Colfax
Curry
De Baca
Doña Ana
Eddy
Grant
Guadalupe
Harding
Hildalgo
Lea
Lincoln
Los Alamos
Luna
McKinley
Mora
Otero
Quay
Rio Arriba
Roosevelt
Sandoval
San Juan
San Miguel
Santa Fe
Sierra
Socorro
Taos
Torrence
Union
Valencia
Out Of State
Your primary role (or the role you are seeking support as)
*
Parent/Caregiver/Adult Family Member
Sibling
Unrelated Adult
School Personnel
State Worker
Healthcare Professional
Behavioral Health Professional
Other:
Professional License/Licensing Approval Authority (for those seeking CE's)
Your answer
What is the age range of youth you are seeking support for?
(Select all that apply.)
*
0–8
9–13
14–17
18–25
Other:
Required
Do you have any specific questions/topics or concerns you would like discussed during this group?
*
Your answer
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Clinical Assessment Group.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report