EMPOWER Behavioral Mental Health Curriculum Interest Form

Behavior Mental Health Curriculum Interest Form

Please complete this form if you are interested in utilizing the curriculum.
Name*

First NameLast Name
Business Email*
example@example.com
Name of Institution*
Type of Program*

Categorical ResidencyCombined ResidencySubspecialty Fellowship
Which one of the following best describes your interest?*

I would like to be a part of the APPD LEARN pilot study that includes faculty development and measuring longitudinal trainee EPA scores.I would like my program to be one of the first programs to use the online curriculum, beta testing/giving feedback to the developers regarding content and functionality.I am not certain but would like more information.
Should be Empty:

Behavior Mental Health Curriculum Interest Form