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Required format:

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BA Strategies Training Registration Form

Thank you for your interest in the BA Strategies Training Program. Please complete the form below to register for a training cohort. If you have have any questions please contact bhskills@uw.edu

Please review the handout below before registering for the BA Strategies Training

BA Training Overview

Attachment:BA Training - Overview_072622 Final.pdf

Please choose the statement that best suits your situation

* must provide value

I would like to register the following amount of people:

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We offer our training in a cohort structure with cohorts of five to ten participants. If you have five or more participants from your organization you would like to have trained in BA, we may be able to build a cohort specifically for your organization and therefore provide you more flexibility on the training timeline. Please reach out to bhskills@uw.edu to register.

Trainee 1

First Name

* must provide value

Last Name

* must provide value

Degree(s)/Licensure

* must provide value

Are you a Psychologist?

Yes

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Email Address

* must provide value

Clinic or Organization Name

* must provide value

Time Zone

* must provide value

Please confirm that you currently carry an active caseload. If you do not carry an active caseload, you should not participate in the training at this time. A large portion of the training requires you to be able to practice BA with actual patients. Without a caseload, you will not be able to complete your training.

Please contact bhskills@uw.ed at the AIMS Center if you have any questions about this.

* must provide value

Yes, I carry an active caseload

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Background with Behavioral Interventions

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Trainee 2

First Name

* must provide value

Last Name

* must provide value

Degree(s)/Licensure

* must provide value

Email Address

* must provide value

Clinic or Organization Name

* must provide value

Time Zone

* must provide value

Yes, I carry an active caseload

reset

Background with Behavioral Interventions

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Trainee 3

First Name

* must provide value

Last Name

* must provide value

Degree(s)/Licensure

* must provide value

Email Address

* must provide value

Clinic or Organization Name

* must provide value

Time Zone

* must provide value

Yes, I carry an active caseload

reset

Background with Behavioral Interventions

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Trainee 4

First Name

* must provide value

Last Name

* must provide value

Degree(s)/Licensure

* must provide value

Email Address

* must provide value

Clinic or Organization Name

* must provide value

Time Zone

* must provide value

Yes, I carry an active caseload

reset

Background with Behavioral Interventions

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Please list the name of the person or institution who will be paying for the training

* must provide value

Please list the best email address to reach the payer

* must provide value

Please provide the payer's mailing address

* must provide value

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Public cohorts are scheduled once per calendar quarter. Upon registration, we will contact you with information on the next available cohort.

Please note that if a cohort does not reach minimum capacity of 6 participants by 2 months prior to the start date, the cohort will not begin and participants will be moved to the following cohort.

Please select the month you prefer to begin training in (select all that apply)

March 2023

Additional questions or concerns

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