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

Profession

What activities did you attend at the event?

Febuary 6th, 2016 9:30 - 1:00

Agreement

By completing this form, you attest that you have participated in all selected activities in thier entirety.

I agree

Objective: Understand basic similarities and differences between short- and long-term group psychotherapy

Did you attend the session in its entirety?

Objective: Identify steps needed to organize and start-up a theme group

Objective: Contrast values and goals of a short-term vs. long-term therapist

Objective: Identify transference phenomena in structured groups

Objective: Consider possibilities of starting a new group

Please rate the following:

Content matched stated objectives.

Usefulness of handouts/AV.

Quality of facilities.

If you rated any of the above questions with 'fair,' 'poor,' 'disagree,' or 'strongly disagree' please explain in detail (e.g. session title, speaker name, situtation):

Please tell us about any objective you feel we accomplished well or poorly.

Please tell us anything about the presenter you found particularly good or bad

Please answer the following:

If faculty spoke about off-label or investigational uses of a product, was that information disclosed to you?

Did you perceive any product/service/company/commercial bias in any educational session you attended or materials you received?

If you answered "Yes" to the above question, please detail the situation below (e.g. session title, speaker name):

How much did you learn as a result of this education program?

Additional comments: