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COVID-19 Resources for Counselors Post-Webinar Survey 3/26

Complete for CE Processing

1.Name:
2.Agency/Company
3.Date of Birth:
4.Mailing Address:
5.Phone Number:
6.Email Address:
7.License Type (e.g., LPC, LMHC, LCSW, LMFT)
8.State Licensed:
9.License #:
10.Are you a National Certified Counselor (NCC) as certified by the National Board for Certified Counselors (NBCC)?
11.Date Training Completed:
Date / Time
Please rate the following items on a scale from 1 to 5.
12.Speaker's presentation style and ability to maintain interest.
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
13.Speaker's knowledge and expertise of the subject.
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
14.Program topic and objectives were clearly stated and met.
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
15.Program content and structure met stated expectations.
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
16.Usefulness of material to my professional practice
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
17.Opportunity for interactions and exercise
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
18.Quality of supplied course materials
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
19.Length of presentation and use of time was effectively managed
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
20.Impression of the overall value of the training session
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
21.Quality of training promotional materials
Poor
Fair/Satisfactory
Average
Above Average
Superior
N/A
22.What did you like the most about the training?
23.What did you like the least?
24.What other training topics would you like to see SMHCA provide?
25.Would you like to receive CEs (continuing education credit) for this training program?
26.Other Feedback/Comments: