4 Hr. Medication Assisted Treatment/Recovery, **VIRTUAL**, 02/01/2023

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Date: Feb 1, 2023 - Feb 1, 2023 Time: 9:00 am - 1:00 pm
Status: Open Registration Deadline: Jan 31, 2023
Trainers Name: Donna L. Potter, Ph.D. & Timothy G. Bax, M.S. Training Site: IHNO: In His Name Outreach Counseling & Recovery Services Address:
576 Dick Rd. Buffalo, New York 14043 Erie County

Credit Hours: 4 Credit Types: CRPA, CARC, SOCIAL WORKER Cost: $100 Schedule:

2/1/23: 9:00 am to 1:00 pm virtually via Zoom

Contact Name: Timothy G, Bax Contact Phone Number: (716) 464-3681 Contact Email Address: [email protected]

Candidate Information
Name*
First Last
Title
Organization*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone Number*
Fax Number
Role with Organization*
- Volunteer
- Staff
- Other
Please Specify Role*
Candidate Plan
Briefly describe your professional experience with addiction recovery, if relevant*
Briefly describe your personal and/or family history with addiction recovery, if relevant*
Explain why you are interested in this training and how you will use it*
Organization Plan
Explain why your organization/agency is interested in this training*
How will this training be used in the delivery of services? Please be specific in describing how you utilize peer recovery coaches*
In a few sentences, describe why your agency/organization is well qualified to integrate the use of peer recovery coaches and/or this training this time*
TOT
Are you applying for the TOT?*
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- Not Applicable
Please describe your training qualifications and give examples of the trainings you have delivered along with two references*
Please describe how your organization will use your ability to train recovery coaches*
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4 Hr. Medication Assisted Treatment/Recovery, **VIRTUAL**, 02/01/2023

Candidate Information

Candidate Plan

Organization Plan

TOT

4 Hr. Medication Assisted Treatment/Recovery, VIRTUAL, 02/01/2023