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Education & Training
8-Hour DEA Training
Mentoring

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Education & Training
8-Hour DEA Training
Mentoring

Home / 8-Hour DEA Training / Become a Buprenorphine Course Instructor

Become a Buprenorphine Course Instructor

Step 1 of 4 - Proposed Course Instructor

25%

All applications will be reviewed by our Clinical Experts and notified accordingly.

Important: Those interested in requesting a Buprenorphine Training should allow a minimum of one month in advance of the training date. This will allow PCSS-MOUD staff adequate time to set up the training.
Name*
First Last
Street Address*
City*
State*
Zip Code*
Email*
Phone*

Please provide your specialty*
Are you board certified in your specialty?*
- Yes
- No
Please indicate your board certifications*
- Addiction Medicine
- Addiction Psychiatry
- Emergency Medicine
- Family Medicine
- Infectious Disease
- Internal Medicine
- Neurology
- OB/GYN
- Pain Management
- Pediatrics
- Psychiatry
Which of the following medications/strategies have you prescribed? (please select all that apply)*
- Buprenorphine (detoxification)
- Buprenorphine (maintenance)
- Methadone
- Naltrexone
- Prescription Opioids
- Opioid Detoxification
- Alcohol Detoxification
For each of the above that you selected, please elaborate and indicate how many years you have prescribed each, to how many patients and in what treatment setting.*
Do you have any supervisory experience in addiction treatment? If so please explain.*
What teaching experience do you have?*
Have you participated in a buprenorphine training as a participant? If so, how many? Have you co-led any buprenorphine trainings with other instructors?*
Do you have any formal addiction training? If so, please explain.*
Why do you want to lead buprenorphine trainings?*
Please describe the audience you wish to teach*
Please provide a copy of your CV
Max. file size: 50 MB.

If you have previously led PCSS-MOUD Buprenorphine Trainings you do not need to attach your CV. If you don't have a digital copy please email a pdf or fax to AAAP: [email protected] or 401-272-0922

Type of Training*
Please select the type of training you wish to lead:

Where did you hear about us?*
- Opioid Response Network (ORN)
- Colleague
- PCSS-MOUD Website
- AAAP Annual Meeting and Trainings
- Facebook
- Twitter
- YouTube
- Email/Newsletter
- Family or Friend
- Magazine/Newspaper
- Search Engine
- Conference

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The content on this site is intended solely to inform and educate medical professionals. This site shall not be used for medical advice and is not a substitute for the advice or treatment of a qualified medical professional.

About
Education & Training
New and Upcoming Activities
8-Hour DEA Training
Mentoring
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About
Education & Training
New and Upcoming Activities
8-Hour DEA Training
Mentoring
Discussion Forum
Contact PCSS-MOUD
News
E-News Sign Up

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Suite 108
East Providence, RI 02914

T (855) 227-2776

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Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.