Individual Renewable Membership: 1 User with 1 Login/Password
$15 Monthly
$100 Annually (save $80)

Institutional Site License Renewable Membership: 1 Site License = 5 Users with Logins/Passwords
  Each Site License for 5 Users-
  $50 Monthly
  $400 Annually (save $200)
  You may choose up to 4 Site Licenses.

First, tell us a bit about yourself:
 

Name/Address Information
  Note: * are required fields.

*First Name: 
*Last Name: 
*Address: 
 
 
*City, State: 
*Zip: 
*Phone: 
Fax: 
*E-Mail: 
 

License Information
Please select the number of licenses you wish to purchase..
 
 

Which category best describes you? (check all that apply)

Behavioral/Mental Health Professional
Health Care Professional
Workplace/Human Resource Professional
Drug Free Workplace Professional
EAP Provider
Criminal Justice Personnel
School Based Educator/Counselor/Support Team
Substance Abuse Prevention or Treatment Practitioner
Researcher/Program Evaluator
Other: Please specify   

Which category best describes your work setting?

University/College
Private Sector
Public/Government
Community-Based Program
Schools (Elementary, Middle, or High School)
Hospital/Primary Health Care Setting
Managed Care Provider
Law/Legal Setting
Other: Please specify   

In which tools are you most interested? (check all that apply)

Screening
Diagnostic
Research/Evaluation
Needs Assessment

Do you plan to use the instrument(s) for clinical or non-clinical purposes?

Clinical    Non-Clinical    Both


Click CONTINUE to review your information and choose your Login Name(s) & Password(s).




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