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SBIRT Training: Individual RSVP Form

August 29 or 30, 2019 - 8am to 12:15pm

@UCSF Mission Bay Conference Center (Fisher Banquet Room East)

1675 Owens Street, San Francisco, CA 94158

Name *
Name
Mailing Address
Mailing Address
Continuing education credit choices include: CME (applies to physicians, nurse practitioners, and physician assistants), PSY, RN, MFT, LCSW, CADC, CATC, CAS, and RAS.
License number is required for participants wishing to receive CME, PSY, and RN credits/ contact hours.
Phone
Phone