Training Participant Profile

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

First Name

Last Name

Street Address

City

State / Country

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

Please take the time to fill out our pre-course profile. This will enable us to customize the training to best meet your professional needs.

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 PPD related work:

Please tell us what you hope to gain from this experience and how it will be useful for your practice:

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 PPD training?

Anything else you would like us to know that would be helpful in the meeting your professional needs?

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We’ll reach out to you if any additional information is needed.