New Forms for the Comprehensive and Supports Waiver

This survey consists of five questions regarding the training you just watched. It also has five survey questions to obtain feedback on your experience. We value your comments and hope to create a positive training experience for everyone.

* 1. Case Manager Name/Provider Name

* 2. Case Manager Agency Name/Provider Agency Name

* 3. What are the reasons a "Third Party Liability" form needs to be completed? (Choose all that apply)

* 4. Who should complete the "Behavioral Support Service" form? (Choose one)

* 5. Crisis intervention services should be added to a plan when....
(Choose one)

* 6. The transportation service......
(Choose all that apply)

* 7. The "Employment Pathway Planning Packet" should be completed when.....
(Choose all that apply)

* 8. Was the content beneficial?

* 9. Was the length appropriate?

* 10. Was the material presented well? (easy to understand, spoken clearly, right tone, etc.)

* 11. Was it worth your time?

* 12. Would you like to have more trainings in the future offered this way?

* 13. Additional Comments: