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Directions: You are being asked to complete this survey because you participated in either a workshop or a seminar at this agency. The survey asks you 1) provide some information about yourself; 2) tell us the services you received; and, 3) let us know how satisfied you are with the services you received. Please respond to the questions honestly. Your answers will be kept private.
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| Please indicate your age. |
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| Which of the following best describes your race/ethnicity? (select all that apply) |
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| What is your primary language? |
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| Please mark the types of problems/concerns you expected to get help with when you came to participate in a workshop/seminar? (select all that apply) |
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| Did you receive the type of help you wanted from the workshop or seminar? |
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| Did you have sufficient opportunities to ask questions? |
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| Was the workshop or seminar interesting? |
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| Did the workshop or seminar provide you with the skills and/or knowledge you need to be able to make changes in your ideas, thinking, and/or behavior? |
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| Do you plan to change your ideas, thinking, or behaviors based on the skills and/or knowledge you received during the workshop or seminar? |
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| How satisfied were you with the QUALITY of the workshop/seminar you received? |
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| How satisfied are you with the AMOUNT OF HELP you received from the workshop/seminar? |
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| How satisfied are you with the CONTENT AND ACTIVITIES of the workshop/seminar? |
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| How satisfied are you with the FORMAT of the workshop/seminar? |
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| Overall, how satisfied are you with the help you received? |
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| If you were to seek help again, would you come back to this agency? |
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