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Community Based Behavioral Health Crisis Intervention (9.58) Training Registration

Thank you for your interest in the Community Based Crisis Intervention Training. Please complete the short registration form. For questions, please email 958Training@health.nyc.gov.
1.First Name(Required.)
2.Last Name(Required.)
3.Email(Required.)
4.Provider Agency – if your agency is not listed, select ‘Other’ and enter your agency’s name.(Required.)
5.Program Type.(Required.)
6.Are you a physician or a qualified mental health professional?(Required.)
7.Is this your first time attending the training or are you renewing your designation?(Required.)