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Welcome
Please fill out and submit this form to register for the training CRS Confidentiality virtual training
8
Questions
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1
I understand that this training is structured for Certified Recovery Specialists/Certified Peers.
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YES
NO
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2
Name
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First Name
Last Name
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3
Email
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example@example.com
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4
Phone Number
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Please enter a valid phone number.
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5
Are you a CRS or CFRS who was certified through the PA Certification Board?
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Yes
No
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6
If you are not a CRS/CFRS what is your credentials and/or job title?
Indicate if you are working towards becoming a CRS/CFRS- You are NOT required to be a CRS for this training
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7
I work with
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SCA
Treatment Provider
Recovery Organization
Recovery Community Center
Other
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8
I work in the following counties
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Bradford
Centre
Clinton
Columbia
Lycoming
Montour
Northumberland
Potter
Snyder
Sullivan
Tioga
Union
Other
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