2025 Kentucky Rural Behavioral Health Symposium Registration

2025 Kentucky Rural Behavioral Health Symposium

Friday, November 21, 2025 - Center for Health Education and Research Building
Name*

First NameLast NameCredentials
Birthdate *

MonthDayYear
Date
Email*
example@example.com
Organization/Employer:*
License #*
Use last 4 digits of Social Security number or four zeros if unlicensed or student.
What county do you practice in?*
If you chose 'other', what county do you practice in?*
Cell Phone Number*

Area CodePhone Number
Do you consent to having your contact information shared with other attendees of this event?*

YesNo
Credit needed*

CMECNESocial WorkKentucky Board of Alcohol and Drug CounselorsCertificate of ParticipationNone
How did you hear about this event?*

Social MediaVia EmailFlyerThrough you employerThrough a friend
Cancellation Notice

If you need to cancel, please cancel within 48 hours of event. To cancel, email Megan McNeal @ megan.mcneal@st-claire.org for catering purposes. Light breakfast and lunch will be provided. Registration fee is free.
If you would like to set up an exhibitor or resource table, please register your organization's table here: https://form.jotform.com/251263936538161
Should be Empty:

2025 Kentucky Rural Behavioral Health Symposium