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Amman-Jordan
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Name
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First
Last
Numbers
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Email
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Nationality
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What is the highest level of education you have completed?
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Bachelor of Science or Arts (BA/BS)
Master of Arts or Sciences (MA or MS)
PhD or other doctorate level
Where are you currently employed?
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Country of current practice :
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How many years of experience do you have in your current job?
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Do you work mainly with :
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Adults
Adolescents
Children
All of the above
Does your work focus on a clinical specialization such as substance use disorder, eating disorders, personality disorder etc? Please specify.
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Have you attended a DBT Intensive Training?
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Yes
No
Do you have any background in DBT? If so, please describe it below.
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If you have completed an Intensive Training, please provide details (when, where, who were the trainers, etc)
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Have you, or are you currently, attending a DBT Skills Class as a leader, coleader, or observer?
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Yes
No
If you answered yes to the previous question, where are you attending the skills class, and who are the other leaders/co-leaders?
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Why do you want to attend DBT Skills Training?
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