CSAT FOLLOW-UP TECHNICAL ASSISTANCE SATISFACTION SURVEY
 

v2.0 
 

 

 

 

 

 

 

Form Approved 

OMB NO. 0930-0197 

Exp. Date 01/31/2014 

CENTER FOR SUBSTANCE ABUSE TREATMENT 

Public reporting burden for this collection of information is 

estimated to average 10 minutes per response to complete this 

questionnaire. Send comments regarding this burden estimate or 

any other aspect of this collection of information to the SAMHSA 

Reports Clearance Officer, Room 7-1045, 1 Choke Cherry Road, 

Rockville, MD 20850. An agency may not conduct or sponsor 

and a person is not required to respond to a collection of 

information unless it displays a currently valid OMB control 

number. The control number for this project is 0930-0197. 

Customer Survey—Technical Assistance Follow-up 

Personal ID code, date of technical assistance, location (i.e., city, state), and topic will be pre-coded and 

entered in this area of the form. 

Please check here ( ) if you have received this survey in error, (i.e., you did not attend the technical 

assistance listed above) and return the uncompleted survey in the enclosed postage-paid envelope. 

PLEASE BASE YOUR ANSWER ON HOW YOU FEEL ABOUT 

THE SESSION NOW. Very Very 

Satisfied Satisfied Neutral Dissatisfied Dissatisfied 

1. How satisfied are you with the overall quality of this technical 1 2 3 4 5 

assistance? 

2. How satisfied are you with the quality of the staff leading the 1 2 3 4 5 

session? 

3. How satisfied are you with the quality of the technical 1 2 3 4 5 

assistance materials? 

4. Overall, how satisfied are you with your technical assistance 1 2 3 4 5 

 experience? 

PLEASE INDICATE YOUR AGREEMENT WITH THESE 

STATEMENTS ABOUT THE TECHNICAL ASSISTANCE. 

5. The material presented in this session has been useful to me in 

dealing with substance abuse. 

Strongly 

Agree

1 

Agree

2 

Neutral

3 

Disagree 

4 

Strongly 

Disagree 

5 

6. The technical assistance enhanced my skills in this topic area. 1 2 3 4 5 

7. The technical assistance was relevant to my career. 1 2 3 4 5 

8. The technical assistance has enabled me to serve my clients 

better. 

1 2 3 4 5 

9. This technical assistance was relevant to substance abuse

 treatment. 

1 2 3 4 5 

v2.0 
 

 

 

 

 

10. I would recommend this technical assistance to a colleague. 1 2 3 4 5 

11. I would take additional technical assistance from CSAT. 1 2 3 4 5 

Very Not 

Useful Useful Neutral Useless Applicable 

12. How useful was the information you received during the 

technical assistance? 1 2 3 4 5 

Yes No 

13. Did you share any of the information from this technical assistance with others? 1 2 

14. Did you share any of the materials from this technical assistance with others? 1 2 

15. Have you applied any of what you have learned in the technical assistance to your work? 1 2 

Very Not 

Useful Useful Neutral Useless Applicable 

16. How useful was the information you received from the CSAT 

staff at the session? 1 2 3 4 5 

What about the technical assistance was most useful in supporting your work responsibilities? 

How can CSAT improve its technical assistance? 

Thank you for completing our survey. 

Return your survey in the enclosed envelope. 

v2.0