MCPP Training Request & Contact Form

MCPP Training Request & Contact Form

Thank you for your interest in the Marcus Crisis Prevention Program (MCPP). Please fill out the form below and one of our team members will contact you shortly.

If you prefer to send us an e-mail or give us a call, our direct contact information can be found scrolling down to the end of this survey.

Please start by telling us your first and last name.*

Please indicate any title(s) that you hold.

If applicable, please indicate the name of your school, company, healthcare system or organization.

If you are not affiliated with a company, you can leave this blank.

What is a good email address that we could reach you at?*

We will start by sending you and email, but we would also appreciate it if you could provide a number that we could reach you at with any follow up questions.

Phone

How would you classify the field of service you work in?

Select all that apply.

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What type of training would you say you are most interested in, at this time?

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Please tell us a little more about how we can support your crisis prevention training needs and what led to you contact us today.

Finally, if you do not mind, please tell us how you heard about our program

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The follow section is not required. However, if you have a moment to tell us a little about your location, we would appreciate it. If not, please continue to scroll down to click submit.

Country

United States of America

State/Province:

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City:

CALL US ☎

Voice: 404-785-9463

EMAIL US ✉

mcpp@choa.org

LOCATION

1920 Briarcliff Road NE Atlanta, GA 30329

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