ANSWER SHEET for 20-hr GLOBAL CE Bundles

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STUDENT INFORMATION *

3 easy steps:

Complete the STUDENT INFORMATION page.
Complete the ANSWER SHEET page.
Select the SUBMIT button to be provided a link to online payment.

Section 1: Student Information

Full Name: *

This is the name that will be included on the Completion Certificate.

Street Address *

City *

State or Province *

ZIP Code (or Postal Code) *

Email Address: *

Please carefully enter your email address, which we will use to send you the Completion Certificate.

Confirm Email Address: *

Do you hold professional healthcare and/or counseling Licenses / Certifications?

If applicable, please identify professional healthcare license(s) and/or certification(s) that you currently hold, and include the name(s) of the agency or agencies.

Do you hold internationally-awarded Breining Institute credentials?

If you have earned one or more internationally-awarded credentials from Breining Institute, please select which ones below (select all that apply):

Registered Addiction Specialist (RAS)

Advanced RAS - Level II (RAS II)

Advanced RAS - Level III (RAS III)

Masters Level - RAS (M-RAS)

Clinical Supervisor Credential (CSC)

Master Counselor in Addictions (MCA)

Certified Women's Treatment Specialist (CWTS)

Medication-Assisted Treatment Counselor (MATC)

Forensic Addictions Counselor (FAC)

Certified Co-occurring Disorders Specialist (CCDS)

Certified Case Manager Interventionist - Associate Level (CCMI-A)

Certified Case Manager Interventionist (CCMI)

Certified Case Manager Interventionist - Masters Level (CCMI-M)

ANSWER SHEET *

Section 2: ANSWER SHEET

Complete Your Answers

Select the correct answer to the questions included within the Course Materials.

You will only need to answer the first nine (9) questions that are included in the Course Material and Exam Questions packet to receive full credit for the course.

After you have selected your answers, proceed to the Course Evaluation page, in order to complete this course.

For which one of the courses below are you submitting this ANSWER SHEET? *

GB22-01: 20-hour GLOBAL Bundle - ONE

GB22-02: 20-hour GLOBAL Bundle - TWO

Question 1. *

Question 2. *

Question 3. *

Question 4. *

Question 5. *

Question 6. *

Question 7. *

Question 8. *

Question 9. *

Select the “Next” button, below, to proceed to the COURSE EVALUATION page.

COURSE EVALUATION *

Course Evaluation

Question 1. *

Did the course cover the content you were expecting?

Yes

It covered some of the information expected

Other

Question 2. *

Briefly, in your opinion, what is the most valuable information that this course provides to professional AOD/SUD counselors?

Course Structure and Content

Question 3. *

Rate the relevance of the subject matter presented.

Very relevant

Somewhat relevant

Not very relevant

Other

Question 4. *

Rate the overall value of the information presented in this course.

Extremely valuable

Somewhat valuable

Not very valuable

Other

Overall Experience

Question 5. *

Based on this experience, would you take another online course on this subject?

Yes

Maybe

Question 6. *

Rate your overall experience of taking this online course.

5 stars: Excellent

4 stars: Very good

3 stars: Average

2 stars: Below average

1 star: Not good

Question 7.

Do you have any other comments or suggestions about this course?

How did you find out about this course? *

Friend, colleague or co-worker

Social media (such as Facebook, LinkedIn)

Program Supervisor or Manager

Licensing or Certification agency

Other

Years in AOD/SUD and/or Healthcare Profession *

How long have you been providing professional AOD/SUD counseling services, or have been in the healthcare profession?

Less than 1 year

1 - 3 years

3 - 5 years

5 - 10 years

10 - 15 years

15 - 20 years

More than 20 years

CE Course Payment

The Completion Certificate Fee for this course is $79.

After you select the “Submit” button below, you will be directed to a payment page where you can charge the fee to a credit card or to a PayPal account.

Please only select the “Submit” button one time.

Once it is successfully submitted, you will see a message on the screen that the ANSWER SHEET was “successfully completed.”

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