User Type
Please answer the following questions as they pertain to you and your setting. If your particular profession or setting is not listed, select the “other” option from the drop-down menu. For example, if you are a psychologist, select “other” for your profession.

The information you provide in the “User Type” and “Patient Characteristics” sections will be used to tailor the course content so it better meets your needs. This information will be kept confidential and will only be used for content customization purposes.
     

Work Address
Street:
City:
State:
    
Zip Code:

Patient Characteristics
Please indicate if any or all of the following patient characteristics apply to your (or your students') practice: