2024 CIT Behavioral Health Professional of the Year Award Nomination Form

With the Mental Health Recovery Board hosting it’s first behavioral health CIT course in May. We would also like to award one personnel from each of our three counties (Clark, Greene, and Madison) who already exemplifies crisis intervention.

Below please share how your nominee has displayed clear, calm communication and approach to crisis situations resulting in de-escalation during a crisis, or how they embrace active listening skills along with other crisis intervention techniques to help keep both clients and community safe.

Question Title

* 1. Your Contact Information

First & Last Name:

Agency:

County:

E-mail:

Phone:

Question Title

* 2. Nominee Information

First & Last Name:

Agency:

County:

Email:

Phone:

Question Title

* 3. Rational for Nomination: Please share how your nominee has displayed clear, calm communication resulting in de-escalation during a crisis, or how they embrace active listening skills along with other crisis intervention techniques to help keep both clients and community safe.

Please complete by the deadline: 5:00pm Monday, April 22, 2024

For questions please contact CIT coordinator Adam Kempf via email adam@mhrb.org