PAA 25323452345345
How would you like your name to appear on your certificate?
Profession
Select Your Profession
Addictions & Substance Abuse Counselor
Counselor
Employee Assistance Professionals
Marriage and Family Therapist
Nurse
Other
Physician
Psychologist
Social Worker
Next
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
Previous
Next
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.
Notice to OhioLicensees: In order for us to report your hours to CE Broker, you MUST provide us with your Ohio 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.Â
CHES MEMBERS ONLY -- Please enter your CHES ID#
Previous
Next
Please rate your satisfaction with the content and quality of the program:
Very Satisfied
Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Dissatisfied
Very Dissatisfied
Previous
Next
Was the educational content scientifically sound?
Yes
No
If no, please explain...
Previous
Next
Did you perceive any commercial bias or influence in the educational content?
Yes
No
If yes, what...
Previous
Next
Did this program improve your competence or performance?
Yes
No
If yes, how...
If no, please explain...
Previous
Next
What did you learn that will help you in your practice?
The program was up-to-date and relevant to my professional practice.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Previous
Next
Were the following objectives met?
Participants will be about to recognize high risk airway situations and develop a course of action
Yes
No
I don't know
Were the following objectives met?
Participants will be about to recognize high risk airway situations and develop a course of action
Yes
No
I don't know
Were the following objectives met?
Participants will be about to recognize high risk airway situations and develop a course of action
Yes
No
I don't know
Previous
Next
Was the location suitable?
Yes
No
Not applicable
The facilities were conducive to learning.
Yes
No
Not applicable
Previous
Next
Were the following objectives met?
ENTER OBJECTIVE OR REMOVE
Yes
No
I don't know
Were the following objectives met?
ENTER OBJECTIVE OR REMOVE
Yes
No
I don't know
Were the following objectives met?
ENTER OBJECTIVE OR REMOVE
Yes
No
I don't know
Were the following objectives met?
ENTER OBJECTIVE OR REMOVE
Yes
No
I don't know
Previous
Next
Rate the following for all instructors
Instructor was knowledgeable about the content.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Not applicable
Rate the following for all instructors
Instructor presented the subject matter clearly.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Not applicable
Rate the following for all instructors
Instructor was responsive.
Strongly Agree
Agree
I don't know
Disagree
Strongly Disagree
Not applicable
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
Not applicable
Additional questions about the instructor(s)
Previous
Next
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.
Previous
Next
How did you attend this course?
Live Online/Live Virtual
Enduring (Recorded) Online
Both
Previous
