Consumer registration

Community Psychoeducation Forum

Training & Professional Development Programs:

Interpersonal Psychotherapy Training

Motivational Interviewing Level One: A Training Program for Mental Health Counselors, Social Workers, and Therapists Working with HIV+ Patients
Level One
Level Two

Winter 2012 Training Brochure and Registation Form

Who Should Attend These Trainings

The primary target audience for these trainings are mental health professionals licensed by the New York State Department of Education and the Board of Regents to practice within the boundaries and scope of their respective profession. Preference is given to licensed clinicians working in Ryan White Part B funded agencies.

Continuing Education Units

Cicatelli Associates Inc. is approved by the American Psychological Association to sponsor continuing education for psychologists. Cicatelli Associates Inc. maintains responsibility for the programs and their content.

HIV/AIDS
Content Notice

CONSUMER FORUM REGISTRATION FORM

For PWHA Consumers - Select the forum you would like to attend, complete the requested information and submit your form online.

Understand your Medications
Select	Locations	Dates	Times
	Hilton Garden Inn Albany Medical Center 62 New Scotland Ave, Albany, NY	Thursday, March 29, 2012	1:00pm – 4:00pm
	Cicatelli Associates Inc. 505 Eighth Ave, 19th Floor New York, NY	Monday, February 13, 2012	1:00pm – 4:00pm

Aging Positively: Growing Old with HIV
Select	Locations	Dates	Times
	FEGS 445 Oak Street, Copiague, NY	Friday, February 3, 2012	1:00pm – 4:00pm
	Cicatelli Associates Inc. 505 Eighth Ave, 19th Floor New York, NY	Tuesday, March 20, 2012	1:00pm – 4:00pm

REQUIRED REGISTRATION INFORMATION
Name
Address
City
State
Zip
Phone
Email
Please answer the following questions to help us support your participation in the forum:
1. Do you have any special dietary needs that we should be aware of? YES NO (if yes, please describe):
2. Do you have any special physical needs that might affect your participation? YES NO (if yes, please specify) blind/visually impaired deaf/hard of hearing wheelchair user/mobility problems Other (please describe):
3. If you would like to receive the registration confirmation, and/or any communication in the event of cancellation, or logistical changes with the event, please provide your preferred mode of contact: Email Phone (voicemail) Regular mail I prefer no communications
To register, please complete all information above and hit submit.

If you require additional Information contact Edward Rowlands below:

You may also register using this PDF form: click for form
please complete and mail, fax or email registration form to:

Edward Rowlands
Cicatelli Associates Inc.
505 Eighth Avenue, 19th Floor, NY, NY 10018
Fax (212) 629-3321 - Phone (212) 594-7741 x 215 –
Email: ERowlands@cicatelli.org

Cicatelli Associates Inc., 505 Eighth Avenue, Suite 1600, New York, NY 10018
phone: (212) 594-7741 / fax: (212) 629-3321
http://www.cicatelli.org