MIMS Training Inquiry Form
Training Options
Teen MHFA can be taught in (4) 90 minute classes OR (7) 45 minute classes. Both the Adult MHFA and the Youth MHFA can be completed in person or online (7 hrs), or in hybrid format (5.5 hrs) with approximately 2.5 hours of online pre-work required.
Please select the training(s) you would like to schedule.
Stop the Bleed
CPR/AED for Adults/Children/Infants
(AHA)
CPR/AED for Adults/Children/Infants
with First Aid
(AHA)
BLS CPR/AED for Adults/Children/Infants (AHA)
CPR/AED for Adults/Children/Infants (EMS Safety)
CPR/AED for Adults/Children/Infants with First Aid (EMS Safety)
BLS CPR/AED for Adults/Children/Infants (EMS Safety)
First Aid ONLY (AHA)
First Aid ONLY
(EMS Safety)
Adult MHFA
Teen MHFA (9th - 12th grade — for teens supporting peers)
Youth MHFA
Motivational Interviewing
Other
If other, please enter below.
Contact Info
First Name
Last Name
Organization
Phone
Email
Preferred contact method :
Email
Phone
Text
Any of the above
Stop the Bleed (approx. 1.5 hours)
Date(s) of training
Start Time
End time
How many participants are expected to attend?
Add another response
CPR/AED for Adults/Children/Infants - AHA (approx. 4-6 hours)
Is this a multi-day training?
Please select...
Yes
No
This training can be offered in three 1.5-hour sessions
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Add another response
CPR/AED for Adults/Children/Infants - EMS Safety (approx. 4-6 hours)
Is this a multi-day training?
Please select...
Yes
No
This training can be offered in three 1.5-hour sessions
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Add another response
CPR/AED for Adults/Children/Infants - BLS (AHA) (approx. 4-6 hours)
Is this a multi-day training?
Please select...
Yes
No
This training can be offered in three 1.5-hour sessions
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Add another response
CPR/AED for Adults/Children/Infants - BLS (EMS Safety) (approx. 4-6 hours)
Is this a multi-day training?
Please select...
Yes
No
This training can be offered in three 1.5-hour sessions
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Add another response
CPR/AED for Adults/Children/Infants with First Aid - AHA (approx 6 hours)
Is this a multi-day training?
Please select...
Yes
No
How many sessions would you like?
Please select...
Two 3-hour sessions
Four 1.5-hour sessions
Choice C
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Would you like your training delivered in-person, hybrid or all online?
In-person
Hybrid (please note this will require participants to complete pre-work prior to the training date)
All online
Add another response
CPR/AED for Adults/Children/Infants with First Aid - EMS Safety (approx 6 hours)
Is this a multi-day training?
Please select...
Yes
No
How many sessions would you like?
Please select...
Two 3-hour sessions
Four 1.5-hour sessions
Choice C
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Would you like your training delivered in-person, hybrid or all online?
In-person
Hybrid (please note this will require participants to complete pre-work prior to the training date)
All online
Add another response
First Aid - EMS Safety (approx. 3 hours)
Is this a multi-day training?
Please select...
Yes
No
This training can be offered in two 1.5-hour sessions
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Would you like your training delivered in-person, hybrid or all online?
In-person
Hybrid (please note this will require participants to complete pre-work prior to the training date)
All online
Add another response
First Aid - AHA (approx. 3 hours)
Is this a multi-day training?
Please select...
Yes
No
This training can be offered in two 1.5-hour sessions
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Would you like your training delivered in-person, hybrid or all online?
In-person
Hybrid (please note this will require participants to complete pre-work prior to the training date)
All online
Add another response
Adult MHFA (approx. 7-8 hours in person or 4.5-5 hours hybrid)
Is this a multi-day training?
Please select...
Yes
No
This training can be offered in two sessions
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Would you like your training delivered in-person, hybrid or all online?
In-person
Hybrid (please note this will require participants to complete pre-work prior to the training date)
All online
Add another response
Teen MHFA (approx. (4) 90 minute OR (7) 45 minute sessions)
Would you like the certification delivered in four (4) or seven (7) sessions?
Please select...
4
7
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Would you like your training delivered in-person, hybrid or all online?
In-person
Hybrid (please note this will require participants to complete pre-work prior to the training date)
All online
Add another response
Youth MHFA
Is this a multi-day training?
Please select...
Yes
No
This training can be offered in two sessions
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Would you like your training delivered in-person, hybrid or all online?
In-person
Hybrid (please note this will require participants to complete pre-work prior to the training date)
All online
Add another response
Motivational Interviewing
Is this a multi-day training?
Please select...
Yes
No
Date of training
Start Time
End time
Date of training
Start Time
End time
How many participants are expected to attend?
Add another response
Contact Information
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