The Holistic Clinician Course
evaluation form
Full Name
First Name
Last Name
Email
example@example.com
Zip Code
How did you hear about this program?
Social Media (Facebook, Instagram, Twitter)
Website
E-Blast (Newsletter)
Friends or Family
Other
Satisfaction Rating?
How would you rate The Mind Body Connection Course? Please rate the following questions below from (1) Very Unsatisfied to (5) Very Satisfied.
The content of the program?
(1) Very Unsatisfied
(2) Unsatisfied
(3) Neutral
(4) Satisfied
(5) Very Satisfied
The knowledge and presentation skills of each program presenter?
(1) Very Unsatisfied
(2) Unsatisfied
(3) Neutral
(4) Satisfied
(5) Very Satisfied
The facility and accommodations if a live program, or online platform if attended virtually?
(1) Very Unsatisfied
(2) Unsatisfied
(3) Neutral
(4) Satisfied
(5) Very Satisfied
The content and quality of the program materials?
(1) Very Unikely
(2) Unlikely
(3) Maybe
(4) Likely
(5) Very Likely
The relevance of the program to professional counselors?
(1) Very Unikely
(2) Unlikely
(3) Maybe
(4) Likely
(5) Very Likely
Preferred Format (check all that apply)
Live
Pre-Recorded
Other
Preferred Time (check all that apply)
9am - 12pm
12pm - 5pm
5pm - 9pm
Other
What kind of activities would you like to see from The Psyched Group in the future? (Check all that apply)
Panels and Conversations
Group Supervision
Referrals
Yoga Classes
Meditation Groups
Online Chatrooms
Best Business Private Practice Classes
Other
Please comment on any additional recommendations.
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