PDBTI Training Registration

Are you registering for an individual or a group?
Group registration available for groups of 3 or more. All others please use the individual registration form.
- Individual Registration
- Group Registration

Group Registration
Group Registration: Please select the event you would like to register your team for.
For more information on any of these events, please visit our training page. https://www.pdbti.org/dbt-training/
- Diving into DBT Skills - January 14th and 15th, 2021 - $325.00 per attendee
- DBT for People with Substance Use Disorders January 28th and 29th, 2021 - $325.00 per attendee
- DBT for Adolescents and Families February 18th and 19th, 2021 - $325.00 per attendee
- DBT in a Nutshell - March 11th and 12th, 2020 - $325.00 per attendee
- Optimizing Eating Disorder Treatments with DBT March 18th and 19th, 2021 - $325.00 per attendee
Agency
Please tell us the name of the agency or group that you are registering. If you are registering a group that is in private practice, please specify Private Practice.
Primary Group Contact*
Please add the name of the primary contact responsible for registering your group.
First Last
Primary Group Contact Phone Number
Primary group contact email address.
Please enter the number of attendees you are registering.*
Group registration requires a team of 3 or more.
Please enter a number greater than or equal to 3.
Please list all attendees, including the primary contact if they are attending.
To add each additional individual, please use the plus sign on the right.
First name Last name Email address Degree / Licensure Direct contact number
Total
$0.00

Individual Registration
Training Registration*
Please Choose Standard or Student registration. Only students currently pursuing degrees in social work or mental health are eligible for Student Registration.
- Standard Registration
- Student Registration
Standard Registration: Please select the events you would like to register for
For more information on any of these events, please visit our training page. https://www.pdbti.org/dbt-training/
- Diving into DBT Skills - January 14th and 15th, 2021
- DBT for People with Substance Use Disorders January 28th and 29th, 2021
- DBT for Adolescents and Families February 18th and 19th, 2021
- DBT in a Nutshell - March 11th and 12th, 2020
- Optimizing Eating Disorder Treatments with DBT March 18th and 19th, 2021
Student Registration: Please select the events you would like to register for
For more information on any of these events, please visit our training page. https://www.pdbti.org/dbt-training/
- Diving into DBT Skills - January 14th and 15th, 2021
- DBT for People with Substance Use Disorders January 28th and 29th, 2021
- DBT for Adolescents and Families February 18th and 19th, 2021
- DBT in a Nutshell - March 11th and 12th, 2020
- Optimizing Eating Disorder Treatments with DBT March 18th and 19th, 2021
Coupon Code
Total
$0.00
Attendee Name*
First Last
Please identify attendee's degree and/or licensure.
- PhD
- PsyD
- MD
- RN
- LCSW
- LPC
- MSW
- MFT
- LMFT
- CADC I
- CADC II
- QMHP
- MA
- BA
- Other
Please list atendee's licensure
Note: Your selections will follow your name on your training completion certificate. Example: Jane Doe, LPC, CADC II
Agency
Affiliation
Attendee Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Extension
Attendees Email*
Please only include the email address of the training participant. Continuing education certificates are issued via email.

Registration Total
$0.00
Billing*
Please select how you or your team will be paying for registration. All team payments must be paid as a single transaction.
- Pay now by credit card
- Invoice and pay by check
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Training registrations will not be guaranteed until payment is received in full.*
Payments by check are due 10 days prior to training.
- I understand
Administrator responsible for invoicing
First Last
Administrator Phone
Please add the phone number of the manager, supervisor, or financial administrator responsible for invoicing.
Administrator Email
Please add the email of the manager, supervisor, or financial administrator who will receive the invoice.
Billing Address
Same as attendee address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How did you hear about us?*
- Colleague
- Email list
- Facebook
- LinkedIn
- ACCBO Website
- Current Employer
- Web Search
- DBT-L Listserv
- DBT-L Listserv
- Other
Can we send info about upcoming trainings?
- Yes
- No
Questions / Comments
CANCELLATIONS AND REFUNDS A $60.00 handling fee will be deducted upon cancellation. Refund requests by fax or email must be received two weeks before the start date.*
- I understand

If you are experiencing technical difficulties completing this form or would like to register by phone, please contact Christopher Williams, 503-290-3295 or cwilliams@pdbti.org

DBT Training Calendar

SPECIAL EVENTS

Learn and Earn Over Lunch Series
November 18^th, 2020

DBT CITI: Comprehensive Implementation
& Training Intensive
2021 | Two-Part, Immersive DBT Experience
Linda Dimeff, PhD

Friends and Family Workshop
Saturday December 12th, 2020
9am to 12pm

Friends and Family Workshop
Saturday January 9th, 2021
9am to 12pm

Diving into DBT Skills:
An Overview of the
New and Old DBT Skills
January 14^th and 15^th, 2021
Andrew White, PhD

DBT for People with
Substance Use Disorders
January 28th and 29th, 2021
Linda Dimeff, PhD

DBT for Adolescents and Families
February 18th and 19th, 2021
Andrew White, PhD

DBT in a Nutshell:
Treating Multi- Diagnostic, Complex Individuals
March 11th and 12th, 2020
Daphna Peterson, LCSW

Optimizing Eating Disorder Treatments with DBT
March 18th and 19th, 2021
Amy Kalasunas, LPCC-S, NCC

See More

News & Updates

PDBTI closed for Thanksgiving, Thursday November 26th

PDBTI will be closed in observance of Thanksgiving, Thursday November 26th. All… Read more >
Post Doctoral Positions at PDBTI for 2021

We are actively recruiting three psychologist residents to join our team in… Read more >
PDBTI statement about the Murder of George Floyd and Our Commitment to Racial Justice

As people who have chosen to support our fellow human beings when… Read more >
DBT Skills for a Pandemic

Our colleagues at Augusta DBT created this amazing handout for applying DBT… Read more >

Telehealth Informed Consent Form

Telehealth Consent Form

Due to the call for social distancing our clinic will be offering all therapeutic services via telehealth using Zoom Video Conferencing. Zoom is a HIPAA compliant telehealth platform. Before you meet with your provider via Zoom you will need to review and sign the Telehealth Informed Consent below. If you have any questions, please reach out to your therapist.

Telehealth Consent Form

Get Started With Us

Considering therapy at Portland DBT Institute?

Click below to get started.

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DBT-LBC Certified Clinicians

We are proud to have clinicians certified by the Linehan Board of Certification, the most stringent certification available regarding the practice of DBT.

Learn More

First name	Last name	Email address	Degree / Licensure	Direct contact number