Attachment 3 ATTC Net Reg Centers

Form Approved

OMB NO. 0930-0216

Exp. Date XX/XX/XXXX

See burden statement on reverse side

Attachment 1-5: ATTC Follow-up Event Customer Satisfaction Survey—Training

Personal Code: First letter of mother’s first name: ___ First letter of mother’s maiden name:___

First digit of social security number: ___ Last digit of social security number: ___

ATTC staff – enter Event Code in this box.

Please check here ( ) if you have received this survey in error, (i.e., you did not attend the training listed above) and return the uncompleted survey in the enclosed postage-paid envelope.
PLEASE BASE YOUR ANSWER ON HOW YOU FEEL ABOUR THE SESSION NOW. How satisfied are you with the overall quality of this training?	Very Satisfied	Satisfied	Neutral	Dissatisfied	Very Dissatisfied
How satisfied are you with the quality of the instruction?
How satisfied are you with the quality of the training materials?
Overall, how satisfied are you with your training experience?
PLEASE INDICATE YOUR AGREEMENT WITH THESE STATEMENTS ABOUT THE TRAINING. The training was relevant to substance abuse treatment.	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
The material presented in this class has been useful to me in dealing with substance abuse.
The training enhanced my skills in this topic area.
The training was relevant to my career.
The training has enabled me to serve my clients better.
This training was relevant to substance abuse treatment.
I would recommend this training to a colleague.
I would take additional training from CSAT.
I have adequate knowledge in this topic area.
I possess the skills required in this topic area.
I am currently effective when working in this topic area.

How useful was the information you received during the training?	Very Useful	Useful	Neutral		Useless	Not Applicable
Did you share any of the information from this training with others?				Yes			No
Did you share any of the materials from this training with others?
Have you applied any of what you learned in the training to your work?
20. Which of the following have been barriers to applying the information/skills learned in this training to your current job? (Check all that apply) _____ Colleagues _____ Staff resources _____ Client needs _____ Policies and procedures _____ Time _____ Need for additional training _____ Financial resources _____ Other (specify: _____________) _____ Supervisor _____ No barriers
What about the training was most useful in supporting your work responsibilities?
How can the ATTC Network improve its training?

Thank you for completing our survey.

Return your survey in the enclosed reply envelope.

Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information to the SAMHSA Reports Clearance Officer, Room 7-1044, 1 Choke Cherry Road, Rockville, MD 20857. An agency may not conduct or sponsor and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The control number for this project is 0930-0216.