Center for Substance Abuse Treatment Feedback Survey

As the National Screening, Brief Intervention and Referral to Treatment Addiction Technology Transfer Center (N-SBIRT ATTC), we are required to report to the Center for Substance Abuse Treatment (CSAT) your feedback concerning the training, technical assistance, or meeting event in which you are participating. The information you provide is very important in determining which aspects of the event are most useful.

We are asking for your feedback immediately following the event and again in one month to get your long term impressions of the event.

Participation is voluntary. You may refuse to participate or discontinue participation at any time should you change your mind without loss of benefits to which you would otherwise be entitled. All responses to the surveys are reported in an anonymous way. We will only record an anonymous personal code that you will provide us on the customer surveys and your name or personal information will never be used in any reporting.

We appreciate your participation in this survey. If you have any questions you may contact IRETA at 412-258-8565 or email info@ireta.org.

Question Title

* CONTACT INFORMATION

Name:

Question Title

* WORK ADDRESS

Agency Name:

Address:

Address 2:

City/Town:

State:

ZIP/Postal Code:

Email Address:

Phone Number:

Question Title

* Are you willing to be contacted for a brief follow up survey about this event in one month?

Yes

Yes? Look for a survey in your inbox in 30 days!

When you click the button below you will redirected to the evaluation survey. It is an anonymous survey and none of the contact information above will be linked.