716 CEU Evaluation Form
Telehealth Tips, SELF-LEARN 

Training Title: Telehealth Tips, SELF-LEARN

Trainer(s): N/A

Time:  N/A

Location: Self-learn

Continuing Education Hours:  2.0 CEU Hours (LMHC/LCSW/LMSW)

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Email *
Name (As you would like it to appear on your certificate) *
License Number *

Participant Licensure and date (Select from drop down):

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Date(s):
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Learning and Experience
On a scale of 1-10 (1 being not at all, 10 being completely), please rate your ability to identify:  
2-3 Billing Tips
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2-3 Ways Implement Telehealth Services 
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1-2 Ways to Work With a Client That Misses Appointments
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2-3 Ways to Respond to Emergency Situations
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1-2 Practices for Facilitating a Group Virtually
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     Did this training provide new knowledge?
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Did this training remind you of prior knowledge related to the course topic?   
*
Did the trainer(s) seem knowledgeable in the content area?
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Did you find the trainer(s) to be effective? 
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Were the training materials (including power-point and handouts) useful?    
*
 If applicable, was the group activity/discussion useful?
 *
Comments or Concerns?
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