The purpose of this form is to collect descriptive participant information and assess changes in course-related knowledge. Results will be used to inform similar future events. It is important to obtain information from all participants to maintain quality of service; however, your participation is voluntary. (OMB No. 0930-0197, Exp. Date 12/31/10)

Public reporting burden for this collection of information is estimated to average 10 minutes per response.  Send comments regarding this burden estimate or any other aspect of this collection of information to SAMHSA Reports Clearance Officer, Paperwork Reduction Project, OMB #0930-0197, 1 Choke Cherry Road, OAS, Room 7-1044, Rockville, MD, 20857.  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.

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