Group and Individual Crisis Intervention Training: Belleville, Ontario, November 18, 19, 20, 2019.
Please take a moment to complete the following information regarding the upcoming training.
Email address *
Please enter your name as you would like it to be printed on your certificate. *
Your answer
Please provide your current position/role at work that resulted in you taking this training. *
Your answer
What prior training do you have in either mental health awareness or emotional crisis intervention ? Please check all that apply:
How many personal traumatic events have you dealt with in the past year? e.g workplace incident, relationship ending, death of person close to you, etc.
In the past year, how many times have you helped someone who was going through a difficult time or had experienced a traumatic event?
The class will run from 8:30 am to 5:00 pm. I understand that full attendance and participation in class exercises is required to receive a certificate for the training. *
I understand that traumatic events including workplace incidents, relationship stress, and suicide will be discussed during this training. I am responsible for my own self-care and will opt out if something is too sensitive for me to participate. *
Please provide a brief outline of the recent event if one was indicated above. If possible, it will be avoided as a role-play scenario for the training.
Your answer
Please provide any information about yourself that you feel may be helpful for the trainer to know in advance.
Your answer
Payment of the course fee must be received or arranged prior to the training. Please indicate your method of payment. *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service