QPR Training Registration Form
Welcome! We at NAMI Utah are delighted that you are interested in this training. For your safety we require you to complete this registration form. It will only take a few minutes.
How did you hear about this training?
If you experience an emergency during a class would you like us to contact someone?
If yes, who should we contact? (name AND phone number)
I understand that NAMI programs are confidential unless teachers believe I am in danger of hurting myself or someone else. If a teacher is worried about my safety they will contact the crisis unit and my emergency contact. I realize this is to protect me and keep me safe:
I give NAMI Utah permission to send me emails (I can opt out at a later time):
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