Public Health Acupuncture of NM
Acudetox Training Registration Form
Dates: August 19,20, and 26, 27. Location: TBA Jemez/Zia NM
Name: _________________________________ Email:__ ___________
Address:______________________________________________ City: _________________________
State: _______ Zip:_____________ Phone 1:____________________Phone 2:___________________
Organization:_______________________________ Position: _________________________________
Highest Level of Education: __________________________ License(s):_________________________
Include the following documents with your registration:
□ A copy of your Resume or a list of positions you have held;
□ A copy of your GED or highest educational degree or unofficial college transcripts;
□ A copy of your COVID Vaccination Card.
At which organization do you plan to practice acudetox __________________________________
Signature of Program Director _____________________________________________________
Printed Name of Program Director__________________________________________________
Is this a □ treatment, □prevention, or □ harm reduction program?
Note: By New Mexico Law, Certified ADSs may only practice within a board-approved substance use treatment, prevention or harm reduction program with supervision by a NM licensed Doctor of Oriental Medicine at least every 6 weeks. Certified ADSs must have a GED and not have been convicted of a crime within the past two years.
Supervised internship of 40 clients.
In order to be NM Certified or get a NADA certificate of completion, you will need to complete the supervised internship. You are responsible for identifying your supervisor – please email Eleni for a list of internship supervisors. All programs need to be approved by PHANM.
Acudetox Didactic Training Part 1 (Didactic and practicum only)
$450.00
– Includes Materials Fee ($50) and Insurance ($30)
Supervised Internship. (Approx cost paid to supervisor)
$300-550
NADA certificate/membership (email Eleni if interested)
$40-70
Scholarships for Part 1 are available for all NM Integrative Wellness MRC members – See next page for details.
Please send your training fee of $450 or all Scholarship documentation by July 9th, 2022 to secure your place. Cancellations 3 weeks before the training start date will receive a 100% refund, one week before start date receive a 50% refund and less than one week no refund.
Please make checks out to PHANM. Please Mail this form with all documents by July 9th, 2022 to:
PHANM, PO Box 35863 Albuquerque, NM 87176
Or scan and email all to PHAofNM@gmail.com We can take payment over the phone.
Public Health Acupuncture of New Mexico — www.PHANM.org for more Information- Thank You!
QUESTIONS? email Eleni: eleni@fredlund.net
Scholarship for Acudetox Training
The state of NM is in need of Medical Reserve Corps volunteers. Public Health Acupuncture of NM is the housing agent for the NM Integrative Wellness Medical Reserve Corps (NM IW MRC). To learn more about this volunteer group, go to www.phanm.org, and see MRC tab.
We will offer free Acudetox training (didactic portion Part 1) to NM IW MRC members.
In order to receive this scholarship, complete the following steps:
1. Sign up as a volunteer NM Integrative Wellness Medical Reserve Corps (45 mins)
Go to https://volunteer.nmmrcserves.org/
Click on: Register now
Go to: Add organizations
Choose: NM Integrative Wellness MRC Unit, by checking the check box, then click the select-it button at the bottom of the window.
Go to account information and create a user name and password. You will need your drivers license information.
Follow the prompts to complete Profile, Identity, Deployment Preference, Contacts, Occupation, Medical History, Licenses etc. You can do each section at your own pace. It takes from 30-45 min. Having your graduation dates, license numbers, vaccination records would be handy, however, not having them doesn’t interfere with your completing most of it.
2. Complete FEMA Trainings 100 and 200 (free online classes) – 6 hrs total.
Go to https://cdp.dhs.gov/femasid Choose Register for a FEMA SID button on Right
Go to: www.training.fema.gov/is/ In the Search IS box enter IS-100.C After reading the course overview, you will notice on the right hand side there are three highlighted links, which are “take this course”, “classroom materials”, and “take final exam” Complete Interactive Web Based Course and the final exam. Save Certificate
Repeat all the steps for IS-200.C
3. Complete Psychological First Aid (free online class –6-7 hours)
Go to: https://learn.nctsn.org Choose PFA tab Create an account. Take the course and the final exam. Save Certificate.
All of the requirements must be completed by July 9th 2022, Send all certificates by email to Eleni
Required Activities for MRC membership
Just FYI an MRC member is required to attend 2 meetings per year. Meetings are 2 hours long, and occur quarterly. Members must also respond to two deployments per year one of which can be the NM annual MRC Volunteer Summit in Albuquerque.
Questions? Contact Eleni Fredlund, NM Integrative Wellness MRC Unit Leader at: eleni@fredlund.net