Contact Information State AK AL AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY United States Canada United Kingdom Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French S. Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, North Korea, South Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau "Palestinian Territory, Occupied" Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic "Taiwan, Province of China" Tajikistan Tanzani Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam "Virgin Islands, British" "Virgin Islands, U.S." Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Please Tell Us More Your relationship to individual with BPD. I am the of the person with BPD. --- Adult Child Aunt/Uncle Boyfriend/Girlfriend Clinician Co-Parent Cousin Ex-Spouse/Co-Parent Fiancé Friend Grandparent Guardian In-Law-Brother/Sister In-Law-Mother/Father In-Law-Son/Daughter Nephew/Niece Parent Partner Sibling Significant Other Spouse Stepparent
Age of individual with BPD
Your relationship to 2 individual with BPD I am the nd of the person with BPD. --- Adult Child Aunt/Uncle Boyfriend/Girlfriend Clinician Co-Parent Cousin Ex-Spouse/Co-Parent Fiancé Friend Grandparent Guardian In-Law-Brother/Sister In-Law-Mother/Father In-Law-Son/Daughter Nephew/Niece Parent Partner Sibling Significant Other Spouse Stepparent
Age of 2
individual with BPD. nd
If you are a clinician, please provide your credentials
Family Connections Preference: (optional)
--- Tele-Connections California, Bakersfield California, Central Coast California, Inland Empire California, Los Angeles California, LA South Bay California, Newport Beach California, Orange County California, Pasadena California, San Fernando Valley California, San Francisco Bay California, Sierra Madre Connecticut, Danbury Connecticut, Fairfield County Georgia, Atlanta Maryland, Baltimore Massachusetts, Belmont Massachusetts, Boston Massachusetts, Cape Cod Minnesota, Minneapolis Minnesota, St. Paul New Jersey, New Brunswick New Jersey, Northeast New York, Albany New York, Binghamton/Elmira New York, Goshen New York, Long Island New York, New York City New York, Rochester New York, Westchester Nevada, Reno North Carolina, Charlotte North Carolina, Mooresville North Carolina, Raleigh/Durham Oklahoma, Oklahoma City Rhode Island, Providence Pennsylvania, Philadelphia Oct 6-7, 2018 Tennessee, Nashville Texas, Austin Texas, Dallas/Fort Worth Texas, Houston Utah, Salt Lake City Virginia, Arlington Washington, Bainbridge Island Washington, DC Washington, Seattle Puerto Rico Canada, Hamilton, Ontario Canada, Ottawa, Ontario Canada, Toronto, Ontario Please choose Tele-Connections if none of the locations are applicable to you
Interest in teaching Family Connections and/or Tele-Connections after finishing this course and receiving further training?
Yes No Maybe
We thank you for your registration - every family is important to us, and we know the burden this illness creates for your family. Please be assured that you will be offered the first possible opening in the class nearest you or in a TeleConnection or weekend class, according to your preference. We have a very limited staff and the growth of the program exceeds our ability for more personalized contact at this time.