2.6 CSAT Customer CSAT Customer Sat Survey Training Follow-up

Form Approved

OMB NO. 0930-0216

Exp. Date XX/XX/XXXX

See burden statement on the reverse side

Attachment 1-4: ATTC Post 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.
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. 5. The training class was well organized.		Strongly Agree	Agree		Neutral	Disagree	Strongly Disagree
6. The material presented in this class will be useful to me in dealing with substance abuse.
7. The instructor was knowledgeable about the subject matter.
8. The instructor was well prepared for the course.
9. The instructor was receptive to participant comments and questions.
10. I am currently effective when working in this topic area.
The training enhanced my skills in this topic area.
12. The training was relevant to my career.
13. I expect to use the information gained from this training.
14. I expect this training to benefit my clients.
15. This training was relevant to substance abuse treatment.
16. I would recommend this training to a colleague.
17. I have adequate knowledge in this training area
18. I possess the skills required in this topic area.
19. How useful was the information you received from the instructor?		Very Useful	Useful		Neutral	Useless	Not Applicable 
20. Please indicate which title best describes your job:
Medical Director Physician Nurse Physician’s Assistant Pharmacist Other (please describe) __________________	Clinical Administrator/Manager Clinical Supervisor Psychologist Counselor Social Worker Manager/Director			Federal Government Official State Government Official County Government Official Researcher Other (please specify)__________
21. Please indicate which best describes your agency or affiliation: Federal Government Substance Abuse Treatment Program State Government University or other higher education institution County Government Other (please describe) __________________________ Local Government 22. What is your gender? Male Female 23. Are you Hispanic or Latino? Yes No 24. What is your race (Mark all that apply)? Black or African American Alaska Native Asian American Indian White Native Hawaiian or Other Pacific Islander
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 to the Survey Administrator for your Session.

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.