Florida Firefighters Safety & Health Collaborative

The Florida Firefighters Safety & Health Collaborative is a free program to fire departments looking to enhance and maintain an effective safety committee or safety program.

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The Collaborative provides free training, protocols, and guidelines that support best practices as they relate to safety and health in the fire service. Contact us today to learn more about how you can help.

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Clinician Awareness Registration Form

First Name*
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Last Name*
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Email*
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Practice Contact Phone Number
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Practice Website
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What is your preferred method of communication?*
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Address
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Apt / Suite #
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City
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State
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Zip Code
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Practice Address(es)
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Please list the full addresses of each of your practice's locations.

Degrees
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Other Degree
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Specialties
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Other Specialties
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Languages Spoken
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Other Languages
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Certifications (CAP, EMDR, etc.)
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Please include board certifications here as well.

Insurance Panels (Cigna, UMR, etc.)
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Home visits?
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Adolescents?
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Faith Based?
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States licensed in?
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Prior to course, your specialty(ies)?
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Previous experience with treating firefighters?
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Privileges or an affiliation with ANY IOP or OP?
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Years in practice
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Years of experience in counseling?
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Immediate Availability?
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Available in less than 24 hours?
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Will you return a call within 3 hours?
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Why can't you return a call within 3 hours?
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Specific skill sets you believe facilitate healing and resiliency for firefighters.
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Please consider referring someone to our program.
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Full Name
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Email
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City
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Full Name
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Email
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City
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Full Name
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Email
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City
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Full Name
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Email
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City
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Full Name
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Email
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City
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Our Ethics Policy

The Florida Firefighters Safety & Health Collaborative is an organization formed to provide our members shared knowledge and resources based on best practices and research available from a myriad of confirmed resources. This website serves as a vehicle to share this information. It is not the intent of our Collaborative to operate for the benefit of private interests, to sponsor or endorse ANY specific agency, vendor, manufacturer or product. Nor is it our intent to support or endorse any political candidate or campaign for elected public office.

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