Training Participant Profile

For the 12-hr Post-Graduate Advanced Training at The Postpartum Stress Center

First Name

Last Name

Street Address

City

State / Country

Pre-Course Reading Materials:

Read the following in preparation for your course: Pre-requisite Materials

What is the date of your course? (Enter the first meeting date if it is a multi-day course)

Are you a...

Professional

Grad Student

If you're a Professional, list 1) your Degree, 2) the year it was obtained, and 3) how many years you've been in the field:

If you're a Grad Student, what Degree are you studying for?

Describe your previous or current experience with PMAD related work:

What do you consider your greatest professional strength?

What do you consider your greatest area of vulnerability in your work?

How did you hear of our training?

Have you attended any other PMAD training? Please list. (If yes, note that a primary objective of this advanced training is to review, apply and enhance what you have learned by studying it through the lens of a Holding therapist.)

What are your expectations of this advanced course? Please be as specific as possible

We have found that your direct involvement in this interactive course will influence how much you gain from this training. Please describe your comfort level speaking in front of the small group in this virtual platform so we can make it most comfortable for you.

What do you hope to gain by training directly with Karen Kleiman? In what ways do you expect this training to be different from other trainings that are available?

Please let us know if you have a specific case or clinical question that you want addressed by sharing some details here so we can be sure to make time for discussing this.

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