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Registration for:
2019 BHA Annual Conference

Wednesday, May 1, 2019

First Name
Last Name
Credentials
Title
Organization
Address
City
State
Zip
Phone
Email (required for email confirmation)
NOTE: You will receive an email confirmation from webserver@moderntymes.com. You may want to add this address to your spam filtering "safe senders" list or whitelist to make sure you receive the message.
Payment type Pay $95 conference fee by:
Credit Card
Check
Purchase Order
Agency Transfer (Reference code BHSB-TC 01)
Please Note: After April 24th, registrations will not be refunded. Registrants who are no-shows will not receive a refund.
Student Rate?
Check to receive discounted student rate of $55.00
(check one of the above payment options)
Limited space available; must bring current student ID.

Workshops Session 1
(choose one)

see workshop details
1. Engaging the LGBTQ Community: A Tool Kit
2. The Mental Health Parity and Addiction Equity Act @ 10: Achieving Non-Discriminatory Access to Treatment
3. Gambling and Problem Gambling: Identifying and Treating
4. Uncertain Journey: What Families Need to be Effective Supporters
5. Empowerment in Aging
6. Innovative Treatment Programs for Veterans at Risk for Self-harm
Workshops Session 2
(choose one)

see workshop details
1. Creating a Culture of Work
2. Thriving in the Post-Secondary Education Setting: Strategies and Supports for Students Living with Behavioral Health Disorders
3. Data Informed Decision-making: Two Examples of Using Data to Inform Behavioral Health Policy, Program Planning and Quality Improvement
4. Treating Those Affected by Trauma in Educational Settings
5. Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Schools
6. Non-Violent Crisis Prevention Intervention
Attendance verification Continuing Education Units (CEU)
For social workers, psychologists, professional counselors, therapists, and alcohol and drug counselors
Certificate of Attendance (COA)
For nurses and all other disciplines

PO Number

(purchase orders only)

Hearing interpreter
(Check if required)
Please call 410-646-7758 for interpreter

Special Accommodations
(Check if required)
NOTE: This does not include food.
Please describe any special accommodations required.