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Motivational Interviewing Training Interest Form (September 2026)
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1.
First and Last Name
(Required.)
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2.
Email Address
(Required.)
3.
What is your job title and role?
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4.
Supervisor's First and Last Name
(Required.)
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5.
Supervisor's email address
(Required.)
6.
Will you be seeking CEUS for your participation?
Yes
No
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7.
Are you available to take part in this in-person training at the SSW for two full days (9:00 am - 4:00 pm) on both 9/16 and 9/17?
(Required.)
Yes
No
Other (please specify)
8.
Do you have the time and capacity to provide comprehensive feedback following the training to inform the delivery and content for future audiences?
Yes
No
If no, please explain.
9.
On a scale of 1-10 with 1 being "novice level" and 10 being "expert level", how would you rate your current understanding of Motivational Interviewing?
1
5
10
Clear
10.
Please describe your experience with Motivational Interviewing, including any prior training you have completed.
11.
Please describe your experience working in or with child welfare settings.
12.
Please share what you hope to gain from participation in Motivational Interviewing training.
Thank you for taking the time to complete this survey!