QMHP Training Course Signup
Participant Registration Form
Name (as registered with MHACBO)
*
First Name
Last Name
Current Agency where you work (if you are employed)
County where you are primarily employed (if you are employed)
Please Select
Baker County, OR
Benton County, OR
Clackamas County, OR
Clatsop County, OR
Columbia County, OR
Coos County, OR
Crook County, OR
Curry County, OR
Deschutes County, OR
Douglas County, OR
Gilliam County, OR
Grant County, OR
Harney County, OR
Hood River County, OR
Jackson County, OR
Jefferson County, OR
Josephine County, OR
Klamath County, OR
Lake County, OR
Lane County, OR
Lincoln County, OR
Linn County, OR
Malheur County, OR
Marion County, OR
Morrow County, OR
Multnomah County, OR
Polk County, OR
Sherman County, OR
Tillamook County, OR
Umatilla County, OR
Union County, OR
Wallowa County, OR
Wasco County, OR
Washington County, OR
Wheeler County, OR
Yamhill County, OR
E-mail
*
Confirmation Email
example@example.com
Phone Number
*
PART ONE: Select a QMHP Part One class to attend this 4-hour online class
*
July 22, 2025: 4:00pm-8:00pm
August 12, 2025: 4:00pm-8:00pm
September 2, 2025: 4:00pm-8:00pm
PART TWO: Select a QMHP Part Two class to attend this 4-hour online class
*
July 23, 2025: 4:00pm-8:00pm
August 13, 2025: : 4:00pm-8:00pm
September 3, 2025: 4:00pm-8:00pm
Tell us about yourself, how do you identify your race/ethnicity?
*
Please Select
African American/Black
Middle Eastern/North African
Native American or Alaskan Native
Hawaiian/Pacific Islander
Asian
Hispanic/Latino/Latina/Latinx
Multiracial
Non-Hispanic While
Other
Gender?
*
Please Select
Male
Female
Transgender
Nonbinary
Other
How many years have you been working in behavioral health?
*
Please Select
1 or less
2
3
4
5
6
7
8
9
10 or more
How anxious are you about taking a QMHP Exam?
Not anxious at all
1
2
3
4
Extremely anxious
5
1 is Not anxious at all, 5 is Extremely anxious
Submit
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