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ANSWER SHEET - FLORIDA
Last Name First Name MI
Today’s Date
mm/dd/yyyy
License 1
License # or
Certificate #
State where licensed   Title
Expiration Date
mm/dd/yyyy
Other Title:
License 2 (if applicable)
License # State where licensed   Title
Expiration Date
mm/dd/yyyy
Other Title:

Mailing Address
City State Zip
Phone
Fax Email

For True/False questions: A=True and B=False.

Click your answers.
SUBJECTIVE WELL-BEING (HAPPINESS)
A B C D
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A B C D
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HEALTHY PERSONALITY
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A B C D
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ETHICS AND BOUNDARY ISSUES
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DOMESTIC VIOLENCE
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HEALTHY AGING
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ETHICS AND BOUNDARY ISSUES: CASE STUDIES I
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ETHICS AND BOUNDARY ISSUES: CASE STUDIES II
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WOMEN'S HEALTH
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WOMEN'S HEALTH II
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PREVENTION OF MEDICAL ERRORS
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ETHICS AND BOUNDARY ISSUES: CASES AND COMMENTARY I
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A B C D
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ETHICS AND BOUNDARY ISSUES: CASES AND COMMENTARY II
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POSITIVE PSYCHOLOGY I
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POSITIVE PSYCHOLOGY II
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POSITIVE PSYCHOLOGY III
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POSITIVE PSYCHOLOGY IV
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SUICIDE: RISK, ASSESSMENT, AND INTERVENTION
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PREVENTION OF MEDICAL ERRORS II
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A B C D
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Subjective Well-Being (Happiness) $49 $
Healthy Personality $49 $
Ethics and Boundary Issues $49 $
Domestic Violence $49 $
Healthy Aging $49 $
Ethics and Boundary Issues: Case Studies I $49 $
Ethics and Boundary Issues: Case Studies II $49 $
Women's Health $49 $
Women's Health II $49 $
Prevention of Medical Errors $49 $
Ethics and Boundary Issues: Cases and Commentary I $59 $
Ethics and Boundary Issues: Cases and Commentary II $59 $
Positive Psychology I $59 $
Positive Psychology II $59 $
Positive Psychology III $59 $
Positive Psychology IV $59 $
Suicide: Risk, Assessment, and Intervention $59 $
Prevention of Medical Errors II $59 $
Total for all courses $


Please return my Certificates of Completion by mail.
Please return my Certificates of Completion to fax number above.
Please return my Certificates of Completion to the following e-mail address.


COURSE EVALUATION (OPTIONAL)
If you do not wish to complete the evaluation you may skip this step and continue submitting your answer sheet by clicking the "Submit" button below.

Please respond to the following questions utilizing this Likert Scale.
Strongly Agree - 5
Agree - 4
Neutral - 3
Disagree - 2
Strongly Disagree - 1

1. Course content was comprehensive. 1 2 3 4 5
2. Course information was clearly presented. 1 2 3 4 5
3. Course format was well planned. 1 2 3 4 5
4. The course was effectively executed. 1 2 3 4 5
5. Program content was beneficial to me. 1 2 3 4 5
6. Learning objectives were clearly stated at the onset of the course. 1 2 3 4 5
7. Learning objectives were specific and measurable. 1 2 3 4 5
8. The learning objectives met my professional needs. 1 2 3 4 5
9. Course presentation met the stated learning objectives. 1 2 3 4 5
10. The author was knowledgeable of the subject matter. 1 2 3 4 5
11. I would recommend this course to a colleague. 1 2 3 4 5
12. I would take another course from this author. 1 2 3 4 5
13. I valued the course information. 1 2 3 4 5
14. The course met my professional expectations. 1 2 3 4 5
15. Please comment on strengths and weaknesses of this program.
16. Please suggest any improvements you recommend to this program.




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