DBT Skills Introduction & Fundamentals Training

Name *

First

Last

Numbers *

Email *

Nationality *

What is the highest level of education you have completed? *

Where are you currently employed? *

Country of current practice : *

How many years of experience do you have in your current job? *

Do you work mainly with : *

Does your work focus on a clinical specialization such as substance use disorder, eating disorders, personality disorder etc? Please specify. *

Have you attended a DBT Intensive Training? *

Do you have any background in DBT? If so, please describe it below. *

If you have completed an Intensive Training, please provide details (when, where, who were the trainers, etc) *

Have you, or are you currently, attending a DBT Skills Class as a leader, coleader, or observer? *

If you answered yes to the previous question, where are you attending the skills class, and who are the other leaders/co-leaders? *

Why do you want to attend DBT Skills Training? *