Ecotherapy Training Retreat

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July 7-11, 2022 CEU evaluation form

Kindly complete this form and we will email you a certificate for (20) continuing education units within 1 week of you completing this online evaluation.

Please note that we use a scale from 1 - 5 where 5 = "very much" and 1= not much at all"

I am.... *

Wanting CEUs and have signed up in advance for them

NOT wanting CEUs but wuld like to offer my feedback

wanting CEUs BUT did NOT sign up in advance

Other:

Required

Your name: (as it appears on your license or registration) *

Your email (we will send your certificate here) *

Your license number: *

Your license type *

LMFT

LCSW

LPCC

AMFT/Trainee

NONE/ NON-APPLICABLE

Other:

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