Institute for Professional Education

1. Please indicate how interested you are in the following styles of professional education:

	No thanks	Maybe	Sign me up!
EXTENSIVE (ex. up to a year-long course offering a certificate upon completion)	Please indicate how interested you are in the following styles of professional education: EXTENSIVE (ex. up to a year-long course offering a certificate upon completion) No thanks	Maybe	Sign me up!
INTENSIVE (ex. single day or short series of workshops)	INTENSIVE (ex. single day or short series of workshops) No thanks	Maybe	Sign me up!

If you selected "Maybe" please explain here:

2. Would you be interested in a 1-year comprehensive training program in Cognitive Behavioral Therapy (CBT)?

Would you be interested in a 1-year comprehensive training program in Cognitive Behavioral Therapy (CBT)? Yes

No

3. If you answered Yes to Question #2, which of the following schedules would work best for you?

If you answered Yes to Question #2, which of the following schedules would work best for you? One evening per week

One weekend per month

Other (please specify)

4. Are you interested in receiving professional certification? (ex. from an organization such as The Academy of Cognitive Therapy)

Are you interested in receiving professional certification? (ex. from an organization such as The Academy of Cognitive Therapy) Yes

No

5. How much would you be willing to pay for a full year of training in CBT?

How much would you be willing to pay for a full year of training in CBT? $1,000 to $3,000

$3,000 to $5,000

$5,000 to $7,000

More than $7,000

Nothing - I'm not interested

6. If there are other 1 or 2-day intensive workshops you would be interested in learning about, please describe them here:

If there are other 1 or 2-day intensive workshops you would be interested in learning about, please describe them here:

7. Do you have any other comments or suggestions on how Alexian Brothers Behavioral Health Hospital can provide quality professional education programming in the future?

Do you have any other comments or suggestions on how Alexian Brothers Behavioral Health Hospital can provide quality professional education programming in the future?

8. This survey is both confidential and anonymous. However, if you'd like to provide your contact information, we will keep your preferences in mind and contact you when something relevant becomes available.

This survey is both confidential and anonymous. However, if you'd like to provide your contact information, we will keep your preferences in mind and contact you when something relevant becomes available. Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

1. ABBHH Institute for Professional Education Survey