Registration

Counseling with Medication

If you experience a runtime error after the initial submission of your registration profile, then:

Close the browser.
Reopen the browser and go to http://www.counselingwithmedication.com
Log in as a user with the credentials you established when you created your profile.

If you are still unable to access the course, e-mail naadac@naadac.org.

Registration is required to earn credit for this program. After providing the information below, you'll be given a username and password, which you can use to log in to complete the evaluation and print your certificate.

*Required Fields

*User Name:

*Password:

*Confirm Password:

*E-mail:

*Security Question:

*Security Answer:

*First Name:

MI:

*Last Name:

*Phone:

-- ext:

Fax:

*Address 1:

Address 2:

*City:

*State/Province:

*ZIP/Postal Code:

*Country:

BusinessHome

*How did you hear about this program?

*What is the most effective way for you to learn?

*Are you a member of NAADAC?

*Are you certified/licensed as a (check all that apply):
Alcoholism/drug abuse counselor
Prevention specialist
Clinical supervisor
Licensed professional counselor
Rehabilitation counselor
Social worker
Psychologist
Nurse
Physician
Psychiatrist
Clergy
Other

*Primary job function:

*Work setting:

*Are you employed by a facility currently utilizing pharmacotherapies?

Yes - Please list medications utilized
No

*Years of employment in the alcoholism and drug abuse profession:

Highest degree earned:

Race:

Sex:

Year of Birth:

What kind of computer will you use?
Windows PCMacintosh