State PASRR Program Improvement Considerations
How would you like your name to appear on your certificate?
Profession
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Addictions & Substance Abuse Counselor
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How many credit hours did you complete?
Credit Hours (maximum: 1.5)
Agreement
By completing this form, you attest that you have attended the number of hours you have indicated above.
I agree
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Please rate your satisfaction with the content and quality of the program:
Very Satisfied
Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Dissatisfied
Very Dissatisfied
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Was the educational content scientifically sound?
Yes
No
If no, please explain...
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Did you perceive any commercial bias or influence in the educational content?
Yes
No
If yes, what...
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Did this program improve your competence or performance?
Yes
No
If yes, how...
If no, please explain...
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What did you learn that will help you in your practice?
The program was up-to-date and relevant to my professional practiceÂ
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
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Were the following objectives met?
Focus on PASRR successful practice considerations that have emerged since the PASRR regulations were enacted in 1992 and CMS initiated PTAC’s technical assistance role with states in 2009.
Yes
No
I don't know
Were the following objectives met?
Identify practices states may want to consider in order to align the PASRR program with the most current understanding of the PASRR regulations.
Yes
No
I don't know
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Was the location suitable?
Yes
No
The facilities were conducive to learning
Yes
No
Not sure
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Rate the following for all instructors
Instructor was knowledgeable about the content
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Rate the following for all instructors
Instructor presented the subject matter clearly
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Rate the following for all instructors
Instructor was responsive
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Rate the following for all instructors
Instructor used technology, hand outs and other learning aids effectively
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Additional questions about the instructor(s)
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What questions are you having in your practice that you would like to see addressed in an educational activity?
Were questions, concerns and accommodations were addressed efficiently and in a timely manner?
Additional comments, questions or concerns
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