Host a Course
Treatment of Opioid Use Disorder Course Host Interest Form
Thank you for your interest in hosting The ASAM Treatment of Opioid Use Disorder Course: Includes Waiver Qualifying Requirements. Hosting a course requires a minimum of four (4) months advanced notice. Please fill out the below form to initiate the process for setting up a meeting to discuss hosting a course.
Please note that due to a high volume of requests, you can expect a response within 3-5 business days. Meetings are typically scheduled 1-4 weeks from the date of your request.
Who will be hosting the course?
Who will serve as the point of contact for course planning purposes?
What is the best phone number to contact the point of contact?
What is the best email to contact the point of contact?
Please provide the target date for the workshop. Workshops require a minimum of 4 months advanced notice to be scheduled.
Where will the course take place?
How many learners does the host want to reach?
What is the target audience you are trying to reach for this course? Examples: providers in a specific state or geographic region; providers in my hospital system; Ob-Gyn providers
Is there a specific faculty person the host would like to request? All faculty must be approved by ASAM.
If no, use "N/A"
Please enter your comments or questions here.