North Coast AHEC Training Needs Questionaire 2010
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1. Training Needs Assessment

Do you have a suggestion for a training that will benefit you, your practice, patients, or your fellow health center team members? Please submit your suggestion, by completing this questionnaire.

Job Title

Job Category (Check One)

Job Category (Check One) Executive Leadership

Clinician - Medical

Clinician – Behavioral Health

Clinician – Dental

Clinic Manager

Human Resources

Quality Improvement

Technology

Front Office

Back Office

Advocacy

Training

Preferred Methods (Rank 1-4; 1 being most preferred)

	1-most preferred	2	3	4-least desired
In-Person	*Preferred Methods (Rank 1-4; 1 being most preferred) In-Person 1-most preferred	In-Person 2	In-Person 3	In-Person 4-least desired
Video Conference	Video Conference 1-most preferred	Video Conference 2	Video Conference 3	Video Conference 4-least desired
Live Online	Live Online 1-most preferred	Live Online 2	Live Online 3	Live Online 4-least desired
Self-paced Online	Self-paced Online 1-most preferred	Self-paced Online 2	Self-paced Online 3	Self-paced Online 4-least desired

If In-Person, how far are you willing to travel to attend for a one-day training (check one)

If In-Person, how far are you willing to travel to attend for a one-day training (check one) ≤ 30 Miles

30-60 Miles

60-90 Miles

90- 120 Miles

≥ 120 Miles

Anywhere Airport Accessible