| Name: | |
| License type and number (if applicable) | |
| Mailing Address | |
| Telephone Number | |
| Email Address: | |
| Course completed | |
| What is your professional status? |
Licensed Marriage and Family Therapist Licensed Clinical Social Worker Psychologist Alcohol and Drug Counselor Student Unlicensed masters or doctoral level Unlicensed undergraduate degree Other professional |
| What was your primary reason for taking this course? |
Subject was interesting Reputation of leader(s) Recommended by colleague Important to job activities Required by law/regulations |
| Overall, how helpful do you think this workshop will be to your clinical work? |
Extremely helpful Very helpful Somewhat helpful Not that helpful Not helpful at all |
| How would you rate the instructor's knowledge? |
Very high High Average Below average Poor |
| How would you rate the instructor's teaching skill? |
Very high High Average Below average Poor |
| To what degree was this course both consistent with and met its stated goals and objectives. |
Very much Somewhat Not much Not at all |
| How would you rate the materials/handouts for this course? |
Very high High Average Below average Poor |
| How would you rate your satisfaction regarding the cost of this course? |
Very satisfied Somewhat satisfied Not very satisfied Unsatisfied |
| Overall, how would you rate the value of this program? |
Very high High Average Below average Poor |
| Subject matter -- Was the course material helpful? Were their any areas you felt missing? | |
| Did this training (workshop) meet your expectations? If not, do you have suggestions that would improve the training? | |
| Would you recommend this training / facilitator? Please comment. | |