DBT in a Nutshell for Adolescents and Caregivers Attestation Form

DBT in a Nutshell: Treating Multi-Diagnostic, Complex Individuals*
I participated in the teleconference, DBT in a Nutshell: Treating Multi-Diagnostic, Complex Individuals with Leah Smart-Gordon, LCSW on August 25th – 26th, 2022 from 8:30 – 4:00 pm PST. Please accept this as verification that I participated in the event in its entirety.
- I have read and agree to the statement above
Name
First Last
Please enter your name and licensure, exactly as you would like it to appear on your CE certificate.*
Example: Jane Doe, PhD, CADC I
Profession/Discipline:
Email address where you would like your CE certificate delivered.
Can we send info about upcoming trainings?
- Yes
- No
Signature*
By signing below, I verify that I attended this event in its entirety.

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