IAHB Needs Assessment Survey
How would you like your name to appear on your certificate?
Profession
Select Your Profession
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Agreement
By completing this form, you attest that you have attended the activity in its entirety.
I agree
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Profession (Mark all that apply)
Alcoholism/CD Professional
MFCC/MFT
Psychologist
CEAP
Nurse
Social Worker
Counselor (Certified/LPC)
Physician
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What topics would you most like to see us present next year?
Anxiety
PTSD
ADD/ADHD
Personality Disorders
Depression
Anger/Violence
Autism
Other Children's Issues
Other
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If Other, please list.
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What speakers would you most like to see?
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On what day or days of the week would you be most willing/able to attend a seminar?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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How do you usually obtain your continuing education or CME?
Workshop
Convention
Home Study
Grand Rounds
Online
Other
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If Other, please list.
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What is your usual cost per CE/CME hour?
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What is the most important factor in determining what CE/CME you participate in?
Topic
Speaker
Networking with Colleagues
Cost
Location
Other
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If Other, please list.
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Would you participate in a web-based follow-up to a workshop?
Yes
No
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Might this additional resource increase the probability that you would attend?
Yes
No
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How do you think that such a follow-up session might best be used?
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Would you be willing to take a follow-up post-test online a month or so after a workshop?
Yes
No
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Please list any other comments or suggestions.
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Please enter your zip code.
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