Final Clinical Survey-COAMFTE Reporting

Final Clinical Survey
Name*

First NameLast Name
University Email*
example@example.com
Thank you for your willingness to provide feedback on the MAMFT program. This feedback is reviewed by your faculty and the clinical administrative team upon submission. Additionally, as part of our annual reporting to COAMFTE, the MAMFT program provides updated information on graduate achievements. Your responses are confidential and will only be used in an anonymized report that is supplied once a year to COAMFTE.

If you have any questions or comments you would like to share that you were unable to share in this survey please contact the Department Chair, Dr. Mark White, by e-mail (mwhite@nu.edu).
Program Reflection

Reflecting upon your experiences in the program and considering you are near graduation, please consider how well the program prepared you in the following areas:

	Prepared Me Well	Somewhat Prepared Me	Slightly Prepared Me	Did Not Prepare Me
Knowledge of the MFT Profession
Human Diversity & Social Structures
Professional Ethics, Law, & Identity
Practice of Therapy
Research & Evidence-Based Practice

What learning experiences were most and least helpful in preparing you in the above areas?
Based on your overall experiences in the program please rate your agreement with the following statement: The MAMFT program demonstrates a climate of safety, respect and appreciation for all students including those from diverse, marginalized and/or underserved communities.

Strongly AgreeAgreeNeutralDisagreeStrongly DisagreePrefer Not to Answer
Based on your overall experiences in the program please rate your agreement with the following statement: The MAMFT program demonstrates a commitment to diversity, inclusion, and social justice.

Strongly AgreeAgreeNeutralDisagreeStrongly DisagreePrefer Not to Answer
The role of the Program Director (PD) is to provide support for the students and faculty within the MAMFT program to ensure the program is conducted in a manner that helps students achieve their learning outcomes and professional goals.
- Dr. Lisa Kelledy was the PD from 07/17/2014 to 08/22/2019.
- Dr. Asha Sutton was the PD from 08/23/2019 to 10/31/2022.
- Dr. Tracy Oliver became the PD in November of 2022.
Please rate your level of agreement with the following statement: The PD that I had for the majority of my time in the program followed through with their role.

Strongly AgreeAgreeNeutralDisagreeStrongly DisagreePrefer Not to Answer
Future Plans
Do you plan to continue working with your current local supervisor(s) post-graduation?

YesNoUnsure
What are your plans post-graduation related to your site?

Stay with the same site as a hired post-graduatePursuing clinical position at another sitePursuing non-clinical position
Which states do you plan on seeking licensure in? If you are international, enter your location in the box.
Related to licensure, select all that apply:

I have applied to my state licensing board for a post-graduate designation (e.g. LAMFT, LMFT, IMFT, Post-graduate intern)I am scheduled to take the MFT licensing examI have taken the MFT licensing examI reside in the United States, and I have not taken any steps towards applying to a state licensing board at this timeI reside in the United States, and I plan to apply for a clinical license other than the MFT license.I reside in the United States, and I have no plans to seek any sort of license from an eligible state licensing boardI reside outside of the United States, and I have no plans to seek any sort of license from an eligible licensing boardI reside outside of the United States and there is no licensing board for clinical practice
Did you pass the licensing exam?

YesNoDo not know yet
What month and year did you pass the exam?
Which license did you or do you plan on applying for?

Social WorkProfessional Counselor or Mental Health ClinicianSubstance Abuse Counselor Credential
What month and year did you apply for a post-graduate designation (e.g. LAMFT, LMFT, IMFT, Post-graduate intern)?
When are you eligible to apply to the state licensing board for a post-graduate designation?
Do you have plans to pursue doctoral education?

YesNoUnsure
Future Follow-Up
Please provide a non-university email address that the MAMFT Program can use to connect with you on your further achievements. This email address will NOT be shared with any other party or any other university department.
example@example.com
Should be Empty:

Final Clinical Survey

Program Reflection

Future Plans

Future Follow-Up