Mental Health First Aid Training Request Form for Parish and Individual- Diocese of Phoenix

If you would like to request Mental Health First Aid Training, below are points to consider:

The class requires minimal computer skills to register, fill out a pre- and post-evaluation form, and take a quiz on line.
The on-site class lasts 10.00 hours. The class can be completed in 2 half-days. Participants must be present for the entire duration. If you leave during the training, you can reenroll in another class in the near future to obtain credit.
We ask that you bring your lunch; a break will be provided.
This course is a secular course that will also have a Catholic spiritual perspective.
The class size will be a minimum of 5 and a maximum of 30 participants. The Diocesan Pastoral Center (DPC) will also host a monthly class. If the parish or DPC does not have enough participants, participants will be invited from other parishes to attend, as well as the community at large to reach the maximum number. All who want to be a part of improving mental health issues in the community are welcome.
The course is free (a value of $179.00). The manual and guide a value of $29.00 are also free. Our certified trainers volunteer their time. However, if you would like to make a donation to cover the cost of the manual and guide or would like to make a donation of any amount we have a link and QR Code that will be provided. You can also donate via checks, credit card or cash. You can donate as you complete the MHFA online registration process or on the first day. For cash and checks, the instructor will collect the money or checks on the first day.
Hospitality. The course will require a break for lunch or dinner depending on time of day this training will be provided. You will be notified if the parish is providing food. However, feel free to bring your own snacks and drink.
Once confirmation from parish or DPC has been attained, the instructor will contact participants via email to register for the class. This email will include the time, date, location, and next steps.

We look forward to receiving your response! If you are an individual, please fill out the top portion of the page. If you are requesting training for your parish, please fill out the bottom part of form. Thank you!

SIGN UP BELOW (when you click below the request form will open up and provide you with training date options to select from)

I AM REGISTERING AS:*

an individuala parish

Name*

First NameLast Name

Email Address*

example@example.com

Phone Number*

Please enter a valid phone number. If you work for a parish, please include your personal cell number.

Parish/Organization Name *

Parish/Organization Address (optional)

I would like to attend on the following date. Please carefully review the location, dates, times:*

I have taken this course before and have a 2.0 Manual ( and guide). I will not need a new set of books.*

YesNo, I am taking the course for the first time and will need a manual and guide.

Name*

First NameLast Name

Email Address*

example@example.com

Phone Number*

Please enter a valid phone number.

Point of Contact for Parish - to set up class training*

First NameLast Name

Email Address*

example@example.com

Phone Number*

Please enter a valid phone number.

If you are an MHFA Instructor with DPC, please include the name of your co-instructor.

Is your parish team flexible to attend this training at the DPC or a parish as listed below? *

MHFA classes- please check off if you prefer to have your team attend one of these locations instead of hosting at your parish.

If these dates and times listed are not feasible for your parish, would you prefer to host? If so, please provide tentative dates and times.

The class size will be 30. How many participants do you have from your parish? Note: If less than 30, an advertisement will go out to other parishes and community at large to fill the class,-a minimum of 5 participants.

Is your parish willing to provide hospitality services for this training?

How did you find out about this course? *

Upon receipt of this form, Mental Health Ministry will submit your information to the instructors and they will contact you 2-3 weeks before the start of the class date. If you have any questions. Please keep an eye for the next email from MHFA.

Questions? Please email: lassad@dphx.org or call 602.354.2115. Lety Beltran Assad

Mental Health First Aid Training Request Form for Individual or Parish