Behavioral Healthcare Consulting

CONTACT INFORMATION
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I understand that after I register and make payment that I will receive a Training Agreement via fax or e-mail and that I must review, sign and return this form prior to being accepted into the Certification program. NOTE: IF YOU HAVE A PRE-APPROVED PAYMENT PLAN SIMPLY COMPLETE THIS PAGE ONLY AND PRESS THE "SUBMIT REGISTRATION BUTTON BELOW. When you go to the next step (after submission) close that page. If you are paying now you will be completing the next page. Thank you!