Tempe 2008 (October 23-26, 2008) Philadelphia, PA (April 1-4, 2009) Chicago 2009 (April 23-25, 2009) Las Vegas 2009 (June 4-7, 2009) San Diego 2009 (October 1-4, 2009) Scottsdale 2009 (October 22-25, 2009) Magazine Ad E-mail Conference Brochure Friend Marketing Letter Internet Search Newsletter Other Sexual Addiction/Dysfunction Anxiety Disorders Adolescents Eating Disorders Trauma Couples/Relationships Alcohol/Drug Addiction Critical Incident Stress Women's Issues Men's Issues Other Yes No Yes No (for multiple selections, hold down the control button) Other areas of clinical interest: Which conference(s) would you like a brochure on? The following information is optional. Your answers are appreciated and assist us in better aligning our conferences with the needs of our attendees. Are you in private practice? How did you hear about our conference? My clinical area of interest is: Have you attended a summit before? Other way you heard about our conference: * = Required field Comments: *Email: Phone: Eve. Phone: *Zip: Country: *City: Fax: *Address: *State: Facility: *Credentials: *Last Name: *First Name: