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Professional Referral Form
Cooperating with Professionals in the Community

CPC provides information about what AA is, where we are, what we can do, and what we cannot do.

The CPC Committee is seeking contacts with professionals who have contact with alcoholics through their profession. These non-AA groups include:

If you are willing to provide us with contacts in your profession, you can do so in the following ways.

Please fill out the form below with the appropriate information that you feel appropriate to share.

Professional's Information
Your Information
  • Are you willing to make the initial contact with this professional?
  • If so, please fill out the following information about yourself so that we may contact you.
  • Please indicate how the professional that you have recommended might benefit from receiving information about AA. in his or her field. For example, are they involved with professional development? Do they run workshops, conferences or conventions? Does their work involve providing training for colleagues? Do they head an agency? If not, do they know someone in their agency that is involved with professional training programs.

  • Is there any additional information that you can share that might be helpful in making an effective contact with the professional(s) that you have recommended?