NYMHCA's Continuing Education Program
   Continuing Education Workshop Survey
If you attended a NYMHCA or NYMHCA Chapter CEU workshop and did not receive your completion certificate, please fill out the form below.  

Once we receive the completed form we will send you your completion certificate(s).  If you attended multiple CEU workshops, you will need to submit a survey for EACH workshop.
Your Name:
Date:
City/State/Zip:
Mailing Address:
Phone:
Email Address:
License Number:
Certifications:  (CRC/CASAC/NCC)
Number of CEUs:
Workshop Title:
Presenter's Name and Credentials:
 Questions?  Email us
After each question, please evaluate the workshop using the scoring scale as follows:

       1- n/a, 2 - strongly disagree, 3 - disagree, 4 - neither agree nor disagree, 5 - agree, 6 - strongly agree
Achievement of Learning Objectives:  

 1. The workshop helped me to gain an understanding of the material presented.

 2. The workshop helped to enhance my clinical skills.

 3. The workshop trained me to a higher level of competency as a mental health counselor. 

Instructor’s Teaching Ability:

 14. The presenter(s) showed subject matter knowledge and expertise. 

 15. The presentation was clear and effective. 

 16. I acquired new knowledge or skills from this workshop

 17. I would attend another presentation by this/these presenter(s).  

Physical Facilities/Media Support:

 18. The room (lighting, temperature, sound) was conducive to good attention to the speaker(s) and topic.

 19. The room was accessible to the handicapped. 

 20. The visual and auditory support systems functioned so that I could see well. 

 21. The audio-visuals used were readable and understandable.

Program Content Meets Stated Objectives/Usefulness:  

 4. The session clearly focused on the title/objectives as stated in the program.  

 5. These objectives were useful to me in understanding the content presented.  

 6. The content was thought-provoking, and new information/insight was provided.  

 7. “Cutting edge” research was included in the content and the presentation in general.  


Quality of Instruction:

 8. The presenter demonstrated a high level of expertise in the topic presented.

 9. (S)he used credible research findings on the topic.

 10. The presenter presented materials in a clear and orderly fashion.

 11. The materials/concepts presented were at the appropriate conceptual level of the audience.

 12. The presenter responded appropriately to the questions/comments/needs.

 13. The presenter used understandable media to enhance the presentation. (overhead/PowerPoint, etc.)

Date of Workshop: