How would you like your name to appear on your certificate?

Profession

How many credit hours did you complete?

Credit Hours (maximum: 3.0)

Agreement

By completing this form, you attest that you have attended the number of hours you have indicated above.

I agree

Notice to Florida Licensees: In order for us to report your hours to CE Broker, you MUST provide us with your Florida alpha-numeric license number (e.g. CDCA.XXXXXX, LICDCII.XXXXXX, LCDCII.XXXXXX, LICDC.XXXXXX). Please be sure to enter this number accurately, or CE Broker will not record your hours.

Please rate your satisfaction with the content and quality of the program:

Was the educational content scientifically sound?

Yes

No

If no, please explain...

Did you perceive any commercial bias or influence in the educational content?

Yes

No

If yes, what...

Did this program improve your competence or performance?

Yes

No

If yes, how...

If no, please explain...

What did you learn that will help you in your practice?

The program was up-to-date and relevant to my professional practice.

Were the following objectives met?

Understand the psychological concept of the capital-O Other and its role in self identity and psychic stability.

Were the following objectives met?

Identify at least one way in which the Other impacts engagement with others, that is clients, especially when the clients are racially different.

Were the following objectives met?

Understand and practice one skill that will help participants negotiate the Other in cross-racial encounter such that it can facilitate an and I-Thou engagement with an-other person.

Was the technology user friendly?

Yes

No

Not applicable

The facilities were conducive to learning.

Yes

No

Not applicable

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.