Social Worker Boot Camp Evaluation Form

Name of Course:

Enhance Your Career With Elder Law Boot Camp Webinar For Social Workers

Date:

April 7, 2021 • April 14, 2021
April 21, 2021 • April 28, 2021

NAME OF INSTRUCTOR:

Esther Acosta, Attorney and
Counselor at Law

Thank You for Attending the Social Worker Boot Camp

Please complete and submit the evaluation form below in order to receive your 7 continuing education credits.

Name*
First Last
Email*
Attendance Verification Codes
Day 1*
CODE 1
Day 1*
CODE 2
Day 2*
CODE 1
Day 2*
CODE 2
Day 3*
CODE 1
Day 3*
CODE 2
Day 4*
CODE 1
Day 4*
CODE 2
Topics
Please rate each topic on a scale from 1-5 in terms of relevance and practical application:
(1 = least relevant and practical and 5 = most relevant and practical):
Topics*
1 2 3 4 5
Managing Incapacity
Advanced Directives
Medicaid for Long-term Care
Estate Planning for the Elderly
Public Benefits
Caregiver Support
Death of a Loved One
Comments
Course Objectives
Were the course objectives accomplished? Please rate each objective on a scale 1-5
(1 = not met and 5 = objective accomplished)
Were you able to understand the legal strategies and tools needed to assist your elderly patients and clients?*
1 2 3 4 5
Comments
Were you able to identify the legal needs of each particular client or patient type and would you be able to direct them to the appropriate resources?*
1 2 3 4 5
Comments
Instructor
Please rate the instructor on a scale from 1 = poor to 5 = best in terms of presentation skills:
Esther Acosta, Attorney and Counselor at Law*
1 2 3 4 5
Comments
Materials and Overall Experience
Please rate each area on a scale from 1 = poor to 5 = best:
How would you rate the materials you were given?*
1 2 3 4 5
Comments
Please rate your overall Boot Camp experience.*
1 2 3 4 5
Comments
Exit Questions
What did you find most relevant during this Boot Camp event?*
How would you rate the length of the event?*
- Just right
- Too long
- Too short
How did you learn about this event?*
- Direct Mail
- A colleague
- The Internet
Would you refer a colleague to an upcoming Boot Camp event?*
- Yes
- No
Would you attend another Boot Camp again?*
- Yes
- No
Phone
This field is for validation purposes and should be left unchanged.

Acosta Law Firm, PLLC

9305 North Lilley Road
Plymouth, MI 48170

(734) 927-5244

	1	2	3	4	5
Managing Incapacity
Advanced Directives
Medicaid for Long-term Care
Estate Planning for the Elderly
Public Benefits
Caregiver Support
Death of a Loved One

Social Worker Boot Camp Evaluation Form

Name of Course:

Enhance Your Career With Elder Law Boot Camp Webinar For Social Workers

Date:

April 7, 2021 • April 14, 2021 April 21, 2021 • April 28, 2021

NAME OF INSTRUCTOR:

Esther Acosta, Attorney and Counselor at Law

Thank You for Attending the Social Worker Boot Camp

Attendance Verification Codes

Topics

Course Objectives

Instructor

Materials and Overall Experience

Exit Questions

Acosta Law Firm, PLLC

Follow Us

April 7, 2021 • April 14, 2021
April 21, 2021 • April 28, 2021

Esther Acosta, Attorney and
Counselor at Law