CBT-I Registration

Thanks for your interest in the Cognitive Behavioral Therapy for Insomnia course.  Please fill in the form below and then proceed to check out to complete your registration.

Please note the course is limited to 20 participants and registration is on a first-come basis.

* Required fields
Name *
E-mail Address *
Confirm Email Address *
License Number *
Mailing Address *
City, State, Zip *
Phone Number *
I am a: * Psychologist
Other Discipline
I will pay for the course via: * PayPal
Check
If I attend all sessions, I would like a CE certificate: * Yes
No

I have read and agree to the Privacy Policy *

Spam prevention


Please enter the code shown above and click the 'Submit Form' button. This additional step is required to help protect against message spam.

Enter code above: