Intermediate DBT Workshop (In-Person) Registration Form

Intermediate DBT Workshop (In-Person)

11 - 13 Mar 2024 (Mon, Tue & Wed) ; 9.00am - 5.00pm

PREREQUISITES FOR PARTICIPATION

The training is designed for mental health professionals, clinicians, and trainees (e.g., psychologists, psychiatrists, counsellors) who have had introductory exposure to DBT through either a DBT introductory skills training workshop or other training avenues (e.g., Psychwire). To derive the greatest benefit, we encourage participants to review the content taught in the DBT introductory skills training workshop as well as Marsha Linehan’s DBT Skills Training Manual prior to attending the workshop.

Full Name as per NRIC / Passport

Gender

Age

Phone Number

Profession / (student please fill in your educational institution)

Nationality

Have you attended any DBT training/workshop conducted by Dr Pamela Buck and/or Dr Keng Shian Ling prior to this?

Please state the DBT introductory skills training / workshop that you have joined previously (title & date)

Registration Category

If Others for the above, please state:

Only applicable for 'Group of 2' registration. Individual & Student registration kindly proceed to 'Terms & Conditons'.

Second Participant's Full Name as per NRIC/ Passport (if 'group of 2')

Second Participant's Gender (if 'group of 2')

Second Participant's Age (if 'group of 2')

Second Participant's email (if 'group of 2')

Second Participant's Profession (if 'group of 2')

Second Participant's phone number (if 'group of 2')

Second Participant's Nationality

Has Second participant attended any DBT training/workshop conducted by Dr Pamela Buck and/or Dr Keng Shian Ling prior to this?

Please state the DBT introductory skills training / workshop that Second Participant had previously joined

Terms & Conditions:

1. Registration will be closed 3 weeks before the commencement of the program or when we have obtained the maximum number of participants.
2. No cancellations will be accepted before the program. If you are unable to attend, a substitute participant is welcome at no extra charge by informing us in writing at least 1 day before the program. The substitute participant is required to fill-in the online registration form.
3. If a participant needs to withdraw from the workshop due to an emergency or is required to go under quarantine due to Covid-19, the participant can present evidence to the organiser (e.g. a valid medical record/result of Covid-19 test) for the consideration of “forwarding the paid registration fee” to attend another program in the future with same or lower fee. Programs with a higher fee will incur an additional top-up.
4. In the event if the trainer is required to go under quarantine due to Covid-19 or fallen ill, participants will be informed of the postponement of the workshop. The workshop will either be postponed to another date/time or cancelled. Participants will be fully refunded of the registration fees if the workshop is cancelled. However, the organizer assumes no liability for any incidental costs (travel cost, etc.) that a participant might incur as a consequence of the workshop postponement/cancellation

Please check the box
By submitting this registration form, I have read, understood and accept the terms and condition of the workshop stated above.

Intermediate DBT Workshop (In-Person)

11 - 13 Mar 2024 (Mon, Tue & Wed) ; 9.00am - 5.00pm

Address List

Psychological Services

Learning & Development

Payment

InPsych Psychological Services & Training

We have received your registration.

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