* 1. Please provide your name:

* 2. Please provide your email address:

* 3. Please indicate your discipline (check all that apply):

* 4. If you would like Continuing Education Units (CEUs) - available for nurses, social workers and dietitians - please provide your license number:

* 5. Prior to this webinar had you received training on compassion fatigue or vicarious trauma?

* 6. As a result of this training I understand the concepts of Compassion Fatigue, Vicarious Trauma and Burnout (0=not at all true; 10=very true).

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* 7. I am able to recognize the symptoms of  chronic stress (0=not at all true; 10=very true).

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* 8. This training was relevant to the professional work that I do and/or to my personal experience (0=not at all true; 10=very true).

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* 9. I would recommend this training to a colleague or friend (0=not at all true; 10=very true).

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* 10. Please add any additional comments you have about this webinar.

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