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First Name
Last Name
Email*
Personal Email (optional)
Position Title
Primary Profession
Counselor
Addictions Professional
Social Worker
Recovery Specialist
Mental Health Professional
Criminal Justice/Law Enforcement
Community Health Worker
Health Educator
Educator
Administrator
Researcher
Physician
Registered Nurse
PA/APN
Legislator
Student
Vocational Rehab Counselor
Other
Employer
State where you live
New York
New Jersey
Puerto Rico
U.S. Virgin Islands
Other
Organization Address (please include zip code)
Areas of Interest
Supported Employment
Supported Education
Permanent Supportive Housing
Illness Management and Recovery
Assertive Community Treatment
Motivational Interviewing
Suicide Prevention
Trauma Informed Care
School Mental Health
All the above
Other Areas of Interest
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