Please provide the following contact information (optional ):
Where do you work?
Urban
Rural
Government, Federal, State, County, Local
How satisfied are you with the overall quality of this conference?
N/A
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
How satisfied are you with the quality of the information/instruction from this conference?
N/A
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
How satisfied are you with the quality of the conference materials?
N/A
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
The conference was well organized
N/A
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The materials presented in this conference will be useful to me
N/A
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I would recommend this meeting to a colleague
N/A
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Did you stay at the Town and Country Resort & Convention Center?
Yes
No
If no, why?
N/A
Local
Had private accommodations
Cost
Other
Do you have any comments for the Town and Country Resort & Convention Center?
Note: Our
market research has shown that the Town and Country Resort & Convention Center
is the best value for the resources and hotel rates. Changing hotels would
require us to increase room rates to at least $250/night and increase
registration fees.
Have you attended this conference before?
Yes
No
If yes, how many years have you been attending?
1-3 years
4-6 years
7-9 years
10+ years
What was the best (your favorite) part of the conference?
How can we improve our conference?
Would you like to be contacted regarding a specific issue/question? (if yes, please make sure your email address and/or phone number is filled in)
No
Yes
Please indicate which title best
describes your role in relation to this conference.
N/A
Medical Director
Physician
Nurse
Physician's Assistant
Pharmacist
Manager Director
Clinical Administrator/Manager
Clinical Supervisor
Psychologist
Counselor
Social Worker
Federal Government Official
State government Official
County Government Official
Researcher
Other
Please indicate which best describes
your agency or affiliation:
N/A
County Government
Federal Government
Local Government
Mental health/Substance Abuse Treatment Program
State Government
Support or Advocacy Group
University or other Higher education institution
Other
What is your gender?
N/A
Male
Female
Are you Hispanic or Latino?
N/A
Yes
No
What is your race?
N/A
Alaska Native
American Indian
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White