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

Profession

What activities did you attend at the event?

The Movement of Grace

Agreement

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

I agree

Please rate the following:

The program was relevant to my work.

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:

Please rate the speaker(s) as a group. You will have the opportunity to elaborate on an individual speaker in the following question.

If you have additional comments regarding the session or individual speaker(s) - e.g. teaching ability, expertise, organization of materials, etc. - please use the space below:

Having completed the activity, please rate your ability to meet each of the following objectives:

Identify the progression of grace in an addict s journey from active disease through recovery

Evaluate tools they can utilize to enhance this process

Please answer the following:

Do you believe this activity was appropriate for the scope of your professional activities?

Was the educational content scientifically sound?

Was the educational content free of commercial bias?

Was the mode of education effective to learning?

If you answered "No" to any of the above questions, please explain.

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

What did you learn during this activity that you intend to integrate into your practice?

My professional competence would be improved if I had training on:

My professional performance would be improved if I had training on:

My patient outcomes would be improved if I had training on:

Are you interested in basic, intermediate or advanced level trainings?

What barriers might you have that would interfere with implementation of new information learned from this training?

How can this training be improved to better impact competence, performance and/or patient outcomes?

Additional comments: