New Account Questionnaire

Please complete all fields below and submit the questionnaire. We will contact you when your account has been created.
 
Organization
 
Primary Contact
 
Phone
 
Email
 
Address
 
City
 
State
 
Zip
 
Website
 
1.
Program Type (check all that apply)
Residential Treatment Program   
Residential School   
Outdoor/Wilderness Therapy   
Outpatient   
Private School   
Counseling   
Educational Consultant   
Other   
 
2.
Population (check all that apply)
Adolescent   
Adult   
 
3.
Funding
Private
Public
Both
 
4.
Association Memberships: (NATSAP, NAATP, ACA, AACRC, etc.)
 
5.
Please list the instruments you would like to use:
 
6.
Does your program use BestNotes™?
Yes No
 
7.
Are you participating in the NATSAP Research Project?
Yes No
 
8.
Will you be using the Remote Research Director service through Petree Consulting?
Yes No
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