FAMILY CONNECTIONS REGISTRATIONS FORM

Family Connections™ is a 12-week program for relatives with a loved one with borderline personality disorder. For full information, go to the Family Connections™ section on the Home Page. For registration,  complete form below.  Please note there is not a program in every location in the country and so you perhaps might want to consider Tele-Connections which is the course conducted via weekly conference calls.  This registration form includes an option for sign up for Tele-Connections.



Contact Information

  

  

  

Please Tell Us More

Your relationship to individual with BPD. I am the of the person with BPD.

Age of individual with BPD  

Your relationship to 2nd individual with BPD  I am the of the person with BPD.

Age of 2nd individual with BPD.  

Family Connections Preference: (optional)

  Please choose TeleConnections if none of the locations are applicable to you

Interest in teaching Family Connections and/or TeleConnections after finishing this course and receiving further training?

YesNoMaybe

Please enter the text in the grey box into the text field below.

captcha  

Password Reset
Please enter your e-mail address. You will receive a new password via e-mail.