RETAIN Training Feedback Survey

The purpose of this short survey is to gather your feedback on the RETAIN Training.

Question Title

* 1. What best describes your role?

Administrator

Physician

Nurse/Nurse Practitioner

Physical Therapist

Social Worker

Other (please specify)

Question Title

* 2. Please rate your level of agreement with the following statements.

	Strongly Disagree	Disagree	Agree	Strongly Agree
I have a good overall understanding of the purpose of the RETAIN grant.	I have a good overall understanding of the purpose of the RETAIN grant. Strongly Disagree	I have a good overall understanding of the purpose of the RETAIN grant. Disagree	I have a good overall understanding of the purpose of the RETAIN grant. Agree	I have a good overall understanding of the purpose of the RETAIN grant. Strongly Agree
I have a good understanding of how RETAIN can benefit healthcare providers.	I have a good understanding of how RETAIN can benefit healthcare providers. Strongly Disagree	I have a good understanding of how RETAIN can benefit healthcare providers. Disagree	I have a good understanding of how RETAIN can benefit healthcare providers. Agree	I have a good understanding of how RETAIN can benefit healthcare providers. Strongly Agree
I have a good understanding of who can benefit from RETAIN Services.	I have a good understanding of who can benefit from RETAIN Services. Strongly Disagree	I have a good understanding of who can benefit from RETAIN Services. Disagree	I have a good understanding of who can benefit from RETAIN Services. Agree	I have a good understanding of who can benefit from RETAIN Services. Strongly Agree
I know how to refer someone to RETAIN.	I know how to refer someone to RETAIN. Strongly Disagree	I know how to refer someone to RETAIN. Disagree	I know how to refer someone to RETAIN. Agree	I know how to refer someone to RETAIN. Strongly Agree
I like the training format.	I like the training format. Strongly Disagree	I like the training format. Disagree	I like the training format. Agree	I like the training format. Strongly Agree
I was satisfied with the training.	I was satisfied with the training. Strongly Disagree	I was satisfied with the training. Disagree	I was satisfied with the training. Agree	I was satisfied with the training. Strongly Agree

Question Title

* 3. Comments: