L.A. CADA PEER SPECIALIST PILOT TRAINING
I certify that I meet the following criteria:
*
I have worked 1,500 Hours or more in behavioral health
I have lived experience (substance use, mental health, or both, personally, or through family)
I am committed to attend and participate in the schedule of instruction
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth:
*
-
Month
-
Day
Year
Date
Employer:
Supervisor's Name:
First Name
Last Name
Submit
Should be Empty: