After you complete this evaluation form, I’ll email you a digital copy of your certificate, which can be applied to this licensing cycle.

Name

First Name

Last Name

Email:

Date you attended the training

10/28/25

MM

DD

YYYY

What was the most important thing you learned at the CE?

Is there anything else you'd liek to say about the CE?

What would you change about the CE?

Please rate the CE according to the following.

Did not meet expectation

Meet expectations

Exceded expecatation

Would rather not say

What License do you currently have?

(Please check all that apply)

LCSW

LSW

What is your license number?

How many years have you had your license?