2.5 CSAT Customer CSAT Customer Sat Survey Training

National Cross-Site Assessment of Addiction Technology Transfer Centers (ATTC) Network

Attachment 2-5 CSAT Cust Satis Survey Training

ATTC

OMB: 0930-0216

Document [doc]
Download: doc | pdf

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.


  1. How satisfied are you with the overall quality of this training?

Very

Satisfied



Satisfied



Neutral



Dissatisfied


Very Dissatisfied



  1. How satisfied are you with the quality of the instruction?


  1. How satisfied are you with the quality of the training materials?


  1. 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.

  1. 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.


File Typeapplication/msword
File TitleForm Approved
AuthorJennifer Ellingwood
Last Modified Byproth
File Modified2006-11-09
File Created2006-09-28

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