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GoodTherapy.org Winter Teleconference Series

 Survey & CEU Request Form

 

 

To receive a CEU certificate for a GoodTherapy.org event which you participated in,

please complete the following form:

 

 

*Your Full Name as you would like it to appear on your certificate:

*Email associated with your GT Membership:

*Please retype your Email:

*Would you like us to email you a CEU certificate?
.........................
Yes
No

*Start Code (given by the facilitator at the beginning of the teleconference):

*Finish Code: (given by the facilitator at the end of the teleconference):

*In your opinion, how would you rate this workshop on the following factors?

(a) my overall impression

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(b) pace at which material was covered

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(c) relevance of content to my work

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(d) organization of content

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(e) level of content met by needs

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(f) facility resources

4 - Excellent
3 - Good
2 - Fair
1 - Poor
N/A

(g) stated objectives were met

4 - Excellent
3 - Good
2 - Fair
1 - Poor
*The most useful part of the workshop was:
*Suggestions to assist in improving workshop:
*One word you would use to describe this workshop:
*Other comments?
*In your opinion, how would you rate the workshop presenter on the following factors?

(a) knowledge about the subject matter

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(b) well prepared and organized

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(c) used practical examples

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(d) interested and enthusiastic

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(e) sensitive to participants' needs

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(f) encouraged group participation

4 - Excellent
3 - Good
2 - Fair
1 - Poor

(g) provided useful comments/feedback

4 - Excellent
3 - Good
2 - Fair
1 - Poor
*Other comments about presenter:

*Suggestions for future workshops/speakers:

Thank you for taking the time to complete this survey!

If you requested a CEU certificate, we will email it to you within 2 weeks.

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