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Advanced Therapist Mentorship and Experiential Training
Hi there! Please complete this form with your information. Once the form is completed you will be able to schedule yourself for a Free Information Call With Dr. Christie.
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1
Your Full Name
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First Name
Last Name
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2
Your Email
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3
Your Phone Number
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Area Code
Phone Number
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4
How did you find out about CMAT?
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My healthcare providers (eg. Therapist, Primary Care Provider, Social Worker, etc)
Coach
Google
Social Media
Word of mouth/friend
A Therapist Training Program
A Collegue
Other
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Please Select
My healthcare providers (eg. Therapist, Primary Care Provider, Social Worker, etc)
Coach
Google
Social Media
Word of mouth/friend
A Therapist Training Program
A Collegue
Other
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5
Do you have any professional designations?
Please Select
RCC (Registered Clinical Counsellor)
RSW (Registered Social Worker)
RCSW (Registered Clinical Social Worker)
RP (Registered Psychotherapist)
Psychologist
Registered Nurse
Medical Doctor
LPN (Licensed Practical Nurse)
Nurse Practitioner
Marriage and Family Therapist (LMFT)
Chaplain or Spiritual Care Provider
Coach
Other
Please Select
Please Select
RCC (Registered Clinical Counsellor)
RSW (Registered Social Worker)
RCSW (Registered Clinical Social Worker)
RP (Registered Psychotherapist)
Psychologist
Registered Nurse
Medical Doctor
LPN (Licensed Practical Nurse)
Nurse Practitioner
Marriage and Family Therapist (LMFT)
Chaplain or Spiritual Care Provider
Coach
Other
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6
Please provide an overview of your previous Medicine Assisted Therapy (MAT) or Psychedelic Assisted Therapy training. If you have previously completed training specifically with Dr. Devon Christie, please include those details as well.
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7
Please verify you are a human
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8
I attest that the information I have provided is true, accurate and complete to the best of my knowledge.
Afterwards click SUBMIT and you will be directed to booking page to schedule your Information Call
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