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Statement of Interest for Medi-Cal Peer Support Specialist Training 2026

To pre-register, you must complete each response.

Please note that the pre-registration will not be complete unless all questions are fully answered. Thank you! The training is 20 days (four weeks), M-F, 8:30 am- 12:30 pm. A laptop or desktop computer is required, but you may substitute with a tablet or iPad just not a smartphone. Participants may not miss more than 8 hours total. Please note that the pre-registration is not a guarantee of enrollment. After individuals pre-register and we get about three weeks out from the start date of the training, you will start receiving requests for your response. Only those who are responsive in a timely manner will be enrolled. Those who are not responsive or are late in their response may be wait listed for a future class.
1.What is your full name (must match your Driver's License or state issued ID)?(Required.)
2.Have you previously participated in this training?(Required.)
3.Currently we are only accepting applicants from this list of counties, please select the county you currently reside or work in. If your county is not listed, we would like the opportunity to speak with you to explore the possibility of your enrollment. Kindly send an email to diana.echaves@cbhi.net or to james.ritchie@cbhi.net. Please type "Out of jurisdiction inquiry" in the subject line, be sure to include your name, a good contact number, and the county you reside or work in in the body of the email and someone will reach out to you.(Required.)
4.Choose your training dates. Please note that the class size is limited in order to keep the learning experiential and supportive. There is a chance that you may be waitlisted for a given date selection. You will be notified as soon as practicable if you will be waitlisted. After you pre-register, we contact you through email to schedule your required 1 hour orientation and full registration. Individuals who respond to our emails and show up for their scheduled orientation are prioritized.(Required.)
5.What is the best phone number to contact you?(Required.)
6.What is your email address?(Required.)
7.In a few words, please describe your interest in this training program.(Required.)
8.Participating in this training program requires you to have a lived recovery experience defined as personal experience of being a consumer of mental health or substance use disorder services, or as a parent, family member or direct care supporter of someone who does.  Do you have a lived recovery experience, as defined here?(Required.)
9.What is your employment or volunteer status?(Required.)
10.What is the title of your employment/volunteer position?(Required.)
11.What is the name of your employer & program or volunteer placement site?(Required.)
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