Training Request Form Fill out the form below and we will contact you as soon as possible Your name Email Address Phone number Name of Training Organization Speaking Activity Requested Speaking Activity Requested In-person presentation Keynote Panel Opening or closing remarks Webinar or other presentation conducted virtually Other Other What topics are you interested in? What Topics are you Interested In Benzodiazepine deprescribing and post-acute withdrawal Local government policies and programs in response to the opioid crisis Medical Provider/Patient communication Medication-Assisted Treatment Non-opioid pain management Opioid naïve patient and how to treat Opioid prescribing and tapering Substance Use Disorder (SUD) Other Other When is your event? (Date and time of day) Date and time of day) Please tell us about your event Please tell us about your event What is the size of the expected audience? size of the expected audience Event Address Event Address State City State City Zipcode County or counties serving Zipcode County or counties serving Message Message Submit Form
