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 5 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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