(414) 933-7083   |     (414) 933-7883
835 N 23rd Street, Milwaukee, Wisconsin 53233

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Student Interview/Enrollment Form
Personal Information

Additional Information

By signing below, I hereby acknowledge that When training has been completed, my name, picture, email/phone may be posted (i.e. website, social media) as a contact on the TransformationServices, Inc accounts, if future students wish to ask questions regarding my educational experience. I may be agreeing to supervise students in a clinical setting for tuition waiver for CEU hours, or some of my course answers may be used as examples for other students. If I am enrolled in a government (DVR etc.) paid DISTANCE course, I also understand that if I don’t check in weekly for 3 weeks, or if I am registered for the IN-PERSON, have repeated tardiness and/or 3 unexcused absences this may dis-enroll me from this course, and re-enroll me in the next scheduled one. There will be a cost TO ME for this re- enrollment. If I am making financial arrangements, signing here becomes a contractual agreement, per payment receipt.

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CONTACT INFO

  835 N 23rd Street,
      Milwaukee, Wisconsin 53233

  info@transformationservices.info
      drhicks@transformationservices.info

All MH/AODA/Prevention Specialist Education related questions will be answered within 24 hours.

ASKTHEDOC Dr. Hicks will attempt to personally answer as many other requests as soon as possible. However, she cannot guarantee a response, but those queries of general interest will be answered anonymously on her blog (ASKTHEDOC) page, or on any of her more current social media links. Please follow TSI/her Social Media. In doing so, some of those answers may also be used voluntarily in a future publication. In this new political, social and artistic era, Dr. Hicks is especially interested in hearing Substance Abuse and Mental Health Trauma related life stories, and recovery successes from women and men of color (Asian, African-American, Latino, Native American, Indigenous People, Immigrants etc.) regarding all situations and problems-work-relationships-TSI may have just the solution for you!!!

  (414) 933-7083

  (414) 933-7883

835 N 23rd Street
Milwaukee, Wisconsin 53233
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