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Maternal, Child, and Adolescent Health

   
CONFERENCE REGISTRATION FORM - INTIMATE PARTNER VIOLENCE/ DOMESTIC VIOLENCE * Required Fields
CPSP providers and staff will discover that IPV (Intimate Partner Violence/Domestic Violence) is a serious social and public health problem. Participants will learn about the "cycle of violence" and how myths regarding IPV can affect the care given to patients. Steps for screening a patient involved in IPV, as well as the clinic's legal responsibilities, will be explored. The class concludes with practice developing a patient safety plan and documentation of IPV on the patients care plan.

LOCATION: Superior Court Building
600 S. Commonwealth Ave, Suite 800 Los Angeles, CA 90005
Prerequisite: CPSP Basic Training Intended Audience: Comprehensive Perinatal Health Workers (CPHW) and others who provide direct perinatal patient care.
Registration is on a first come first served basis. Registration limited to two persons per provider office.
CONTACT: Christian Murillo At (213-639-6419) Or cmurillo@ph.lacounty.gov
Participant Information
* First name:
* Last name:
Position Title:
Work Organization:
* Street1:
Street2:
* City: State:  Zip: 
* Phone:   Fax:  (e.g.999-999-9999)
* Email:
* Immediate Supervisor's Name:

* Please select 1 next to the class that you would like to attend
Intimate Partner Violence/ Domestic Violence: January 14, 2010, 8:30 am to 12 pm
Intimate Partner Violence/ Domestic Violence: February 11, 2010, 8:30 am to 12 pm
Intimate Partner Violence/ Domestic Violence: March 10, 2010, 8:30 am to 12 pm

* I have received my supervisor's approval to attend the marked session(s):
* I am available to attend any of the sessions I have marked above.
  

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