Please fill out this pre-registration form to be considered for the Concurrent Disorders (CD): Treatment approaches and applications course. Pre-registration is the first phase of course registration process. If you do not submit your pre-registration form, you will not be able to register for the course.

Question Title

* 1. Please indicate your name, email address and work title/position

Question Title

* 2. Briefly describe the patient population with whom you work.

Question Title

* 3. Briefly describe your practice setting and your main responsibilities with patients

Question Title

* 4. Indicate your interest in this course (you may select more than one response)

Question Title

* 5. CAMH staff members, please provide your CAMH email address

T