CSAT BASELINE TRAINING SATISFACTION SURVEY
 

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Form Approved 

OMB NO. 0930-0197 

Exp. Date 01/31/2014 

Public reporting burden for this collection of information is 

estimated to average 10 minutes per response to complete 

the Contact Information Form and this questionnaire. Send 

comments regarding this burden estimate or any other 

aspect of this collection of information to the SAMHSA CENTER FOR SUBSTANCE ABUSE TREATMENT 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—Training 

Please enter the Personal ID code you used on the consent form here ________. 

Date of training, 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 training 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 training? 1 2 3 4 5 

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

3. How satisfied are you with the quality of the training materials? 1 2 3 4 5 

4. Overall, how satisfied are you with your training experience? 1 2 3 4 5 

PLEASE INDICATE YOUR AGREEMENT WITH THESE 

STATEMENTS ABOUT THE TRAINING. Strongly Strongly 

Agree Agree Neutral Disagree Disagree 

5. The training class was well organized. 1 2 3 4 5 

6. The material presented in this class will be useful to me in 1 2 3 4 5 

dealing with substance abuse. 

7. The instructor was knowledgeable about the subject matter. 1 2 3 4 5 

8. The instructor was well prepared for the course. 1 2 3 4 5 

9. The instructor was receptive to participant comments and 1 2 3 4 5 

questions. 

10. I am currently effective when working in this topic area. 1 2 3 4 5 

11. The training enhanced my skills in this topic area. 1 2 3 4 5 

12. The training was relevant to my career. 1 2 3 4 5 

13. I expect to use the information gained from this training. 1 2 3 4 5 

14. I expect this training to benefit my clients. 1 2 3 4 5 

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15. This training was relevant to substance abuse treatment. 1 2 3 4 5 

16. I would recommend this training to a colleague. 1 2 3 4 5 

Very Not 

Useful Useful Neutral Useless Applicable 

17. How useful was the information you received from the 

 instructor? 1 2 3 4 5 

18. Please indicate which title best describes your job: 

___Medical Director ___Clinical Administrator/Manager ___Federal Government Official 

___Physician ___Clinical Supervisor ___State Government Official 

___Nurse ___Psychologist ___County Government Official 

___Physician's Assistant ___Counselor ___Researcher 

___Pharmacist ___Social Worker ___Other (please specify)____________ 

___Other (please describe) ___Manager/Director 

19. Please indicate which best describes your agency or affiliation: 

___Federal Government ___Substance Abuse Treatment Program 

___State Government ___University or other higher education institution 

___County Government ___Other (please describe)_________________________________ 

___Local Government 

20. What is your gender? 1.____Male 2.____Female 

21. Are you Hispanic or Latino? 1.____Yes 2.____No 

22. What is your race (Mark all that apply)? 

____Black or African American ____Alaska Native 

____Asian ____American Indian 

____White ____Native Hawaiian or Other Pacific Islander 

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

How can CSAT improve its training? 

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Thank you for completing our survey. 

Return your survey to the Survey Administrator for you Session. 

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