GRADUATE SURVEY

Name of Graduate
Field is required!
Field is required!
Group
Field is required!
Field is required!
Date of Graduation:
Field is required!
Field is required!
Are You Continuing Your Education?
Field is required!
Field is required!
If yes, what institution are you attending:
Field is required!
Field is required!
In what program?
Field is required!
Field is required!
Name of business/Self employed:
Field is required!
Field is required!
Are You Currently Working as a LMT?:
Field is required!
Field is required!
Job Title:
Field is required!
Field is required!
Date started:
Field is required!
Field is required!
Supervisor name:
Field is required!
Field is required!
Supervisor phone number:
Field is required!
Field is required!
Your Full Name
Field is required!
Field is required!

Please respond to the following:

Instruction: Consider each item separately and rate each item independently of all others.
Circle or highlight the rating that indicates the extent to which you agree with each statement. Please do not skip any item. 5=Strong Agree 4=Agree 3=Acceptable 2=Disagree 1=Strongly Disagree
1. I was informed if there were any credentialing requirements to work in the field.
Field is required!
Field is required!
2. The clinical portion of the program adequately prepared me for my present position.
Field is required!
Field is required!
3.The classroom/laboratory portions of the program adequately prepared me for my present position
Field is required!
Field is required!
4.My instructors were knowledgeable in the subject matter and relayed this knowledge to the class clearly.
Field is required!
Field is required!
5.Upon completion of my classroom training, an extenship site was available to me, if applicable
Field is required!
Field is required!
6.I would recommend this program/institution to friends or family members.
Field is required!
Field is required!
Did the program meet your expectations?:
Field is required!
Field is required!
Were you satisfied with our program:
Field is required!
Field is required!
Additional comments:
Field is required!
Field is required!
Print Name of Graduate:
Field is required!
Field is required!
Signature of Graduate:
Field is required!
Field is required!
Select a date
Field is required!
Field is required!
Submit