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WI Dementia Care Project
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RCAW Dementia
RCAW Dementia
The Dementia online training is available to registrants for six months.
If you have any questions, call (920) 424-1071 or email
regstaff@uwosh.edu
Fields with asterisk are required.
Select the course(s) you wish to enroll in by checking the checkbox below *
Dementia Generalist for Crisis Responders [+$60.00]
Dementia Generalist for Healthcare Providers [+$45.00]
Dementia Generalist for Family and Friends [+$25.00]
Dementia Generalist for Community Members Train-the-Trainer [+$25.00]
Activities of Daily Living [+$25.00]
Discovering Moments of Joy [+$25.00]
Enhanced Communication Techniques [+$25.00]
Epilepsy and Dementia [+$25.00]
Flow of Day [+$25.00]
Managing Crisis Situations for Healthcare Providers [+$25.00]
Managing Crisis Situations for Crisis Responders [+$25.00]
Meaningful Engagement through Activities [+$25.00]
The Sensory Connection [+$25.00]
Wandering and Exit Seeking Behavior [+$25.00]
Participant First Name *
Middle Initial (or NA if none) *
Participant Last Name *
Date of Birth (MM/DD/YYYY) *
Agency Name *
Agency Type *
Please select
Select Your Agency's Type
Advocate Agency
Aging & Disability Resource Center (ADRC)
Assisted Living (AFH, CBRF, RCAC)
County APS
County Crisis
County (Other)
Emergency Medical Services (EMS)
Fire Department
Home Health Agency
Hospital
IRIS
Judicial/Courts
Law Enforcement (Police/Sheriff)
Managed Care Organization (MCO)
Mental Health Provider
Nursing Home
Other Care Facility
Personal Care Agency
State Employee
Supportive Care Agency
If agency type is other please enter here
Nursing Home License #
Agency Address *
Agency City *
Agency State *
Please select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massaschusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wyoming
Wisconsin
Agency Zip Code *
Agency County *
Please select
Select Your Agency's County
Adams
Barron
Ashland
Bayfield
Brown
Buffalo
Burnett
Calumet
Chippewa
Clark
Columbia
Crawford
Dane
Dodge
Door
Douglas
Dunn
Eau Claire
Florence
Fond du Lac
Forest
Grant
Green
Green Lake
Iowa
Iron
Jackson
Jefferson
Juneau
Kenosha
Kewaunee
La Crosse
Lafayette
Langlade
Lincoln
Manitowoc
Marathon
Marinette
Marquette
Menominee
Milwaukee
Monroe
Oconto
Oneida
Outagamie
Ozaukee
Pepin
Pierce
Polk
Portage
Price
Racine
Richland
Rock
Rusk
Sauk
Sawyer
Shawano
Sheboygan
St. Croix
Taylor
Trempealeau
Vernon
Vilas
Walworth
Washburn
Washington
Waukesha
Waupaca
Waushara
Winnebago
Wood
Out of State
Position Title *
Daytime Phone Number (Use format 000-000-0000) *
Email Address (for registration confirmations) *
Supervisor Full Name
Supervisor Email
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