{"id":42740,"date":"2026-09-21T10:11:37","date_gmt":"2026-09-21T17:11:37","guid":{"rendered":"https:\/\/www.breining.edu\/?page_id=42740"},"modified":"2026-09-23T13:23:21","modified_gmt":"2026-09-23T20:23:21","slug":"course-no-ee26-03-student-information","status":"publish","type":"page","link":"https:\/\/www.breining.edu\/index.php\/course-no-ee26-03-student-information\/","title":{"rendered":"Course No. EE26-03: STUDENT INFORMATION"},"content":{"rendered":"<form method=\"post\" enctype=\"multipart\/form-data\" id=\"vfbp-form-138\" class=\"vfbp-form\"><div style=\"display:none;\"><label for=\"vfbp-EMAIL-AN8fuQyoDLXem\">If you are human, leave this field blank.<\/label><input size=\"25\" autocomplete=\"off\" type=\"text\" name=\"vfbp-EMAIL-AN8fuQyoDLXem\" value=\"\" id=\"\"><\/div><input type=\"hidden\" name=\"_vfb-timestamp-138\" value=\"1791667794\" id=\"\"><input type=\"hidden\" name=\"_vfb-form-id\" value=\"138\" id=\"\"><section class=\"vfb-page-section\"><h3 class=\"vfb-page-title\">Instructions<\/h3><div class=\"vfb-col-12 vfb-fieldType-page-break\" id=\"vfbField4281\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField4282\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4282\" class=\"vfb-control-label\"><\/label><div class=\"\"><h2><span style=\"color: #008000;\">3 easy steps:<\/span><\/h2>\n<ul>\n<li>\n<h4>Complete the <span style=\"color: #008000;\">STUDENT INFORMATION<\/span> and the <span style=\"color: #008000;\">COURSE EVALUATION<\/span> sections.<\/h4>\n<\/li>\n<li>\n<h4>Complete the <span style=\"color: #008000;\">ANSWER SHEET.<\/span> After you answer at least 70% of the questions correctly, you will see a link to continue to the payment page.<\/h4>\n<\/li>\n<li>\n<h4>Make your credit card <span style=\"color: #008000;\">PAYMENT<\/span> for the course, and you will then be automatically emailed a CE Completion Certificate.<\/h4>\n<\/li>\n<\/ul>\n<hr \/>\n<h2><span style=\"color: #000000;\"><span style=\"color: #008000;\">Instructions<\/span><br \/>\n<\/span><\/h2>\n<h3><span style=\"color: #000000;\">Course Material and Questions<\/span><\/h3>\n<ul>\n<li>\n<h4>You should have already downloaded and reviewed the Course Material and Questions packet for this course.<\/h4>\n<\/li>\n<li>\n<h4>The Course Material and Questions packet is a <strong>free download<\/strong>.<\/h4>\n<\/li>\n<li>\n<h4>You will use this online Answer Sheet to answer the Questions in the Course Material.<\/h4>\n<\/li>\n<\/ul>\n<h3><span style=\"color: #000000;\">Online Answer Sheet<\/span><\/h3>\n<ul>\n<li>\n<h4>After you answer at least 70% of the questions correctly, you will select a link to continue to the payment page.<\/h4>\n<\/li>\n<li>\n<h4>At the payment page, you will be able to make a credit card payment for the course, and will then be automatically emailed a Completion Certificate.<\/h4>\n<\/li>\n<\/ul>\n<\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><\/section><section class=\"vfb-page-section\"><h3 class=\"vfb-page-title\">Student Info<\/h3><div class=\"vfb-col-12 vfb-fieldType-page-break\" id=\"vfbField4283\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-form-group vfb-col-12\"><div><div class=\"\"><\/div><span class=\"vfb-help-block\"><h2><span style=\"color: #008000;\">Student Information\r\n<\/span><\/h2><\/span><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField4284\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4285\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4285\" class=\"vfb-control-label\">Full Name: <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4285\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4285\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4286\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4286\" class=\"vfb-control-label\">Street Address <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4286\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4286\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4287\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4287\" class=\"vfb-control-label\">City <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4287\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4287\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4288\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4288\" class=\"vfb-control-label\">State or Province <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4288\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4288\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4289\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4289\" class=\"vfb-control-label\">ZIP Code (or Postal Code) <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4289\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4289\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField4290\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4290\" class=\"vfb-control-label\">Email Address: <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-help-block\">Please carefully enter your email address, which we will use to send you the Completion Certificate.<\/span><input id=\"vfb-field-4290\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"email\" name=\"vfb-field-4290\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField4291\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4291\" class=\"vfb-control-label\">Confirm Email Address: <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4291\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" data-vfb-equalto=\"#vfb-field-4290\" type=\"email\" name=\"vfb-field-4291\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4292\"><label for=\"vfb-field-4292\" class=\"vfb-control-label\">What type of device you are using to complete this online Answer Sheet? <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4292-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4292\" value=\"Desktop computer\">Desktop computer<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4292-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4292\" value=\"Laptop computer\">Laptop computer<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4292-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4292\" value=\"Tablet\">Tablet<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4292-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4292\" value=\"Smart phone\">Smart phone<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4292-4\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4292\" value=\"Other\">Other<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4292-5\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4292\" value=\"I do not know\">I do not know<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4293\"><label for=\"vfb-field-4293\" class=\"vfb-control-label\">Which Web browser are you using to complete this online Answer Sheet form? <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4293-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4293\" value=\"Google Chrome\">Google Chrome<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4293-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4293\" value=\"Safari\">Safari<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4293-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4293\" value=\"Microsoft Edge\">Microsoft Edge<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4293-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4293\" value=\"Firefox\">Firefox<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4293-4\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4293\" value=\"Opera\">Opera<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4293-5\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4293\" value=\"Internet Explorer\">Internet Explorer<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4293-6\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4293\" value=\"Brave\">Brave<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4293-7\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4293\" value=\"Other\">Other<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4293-8\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4293\" value=\"I do not know\">I do not know<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-checkbox\" id=\"vfbField4294\"><label for=\"vfb-field-4294\" class=\"vfb-control-label\">Why are you completing this course? <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-help-block\">Please select all that apply.<\/span><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4294-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4294\" required=\"required\" type=\"checkbox\" name=\"vfb-field-4294[0]\" value=\"1\">Licensing agency requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4294-1\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4294\" type=\"checkbox\" name=\"vfb-field-4294[1]\" value=\"1\">Certification agency requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4294-2\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4294\" type=\"checkbox\" name=\"vfb-field-4294[2]\" value=\"1\">Registration requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4294-3\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4294\" type=\"checkbox\" name=\"vfb-field-4294[3]\" value=\"1\">Employer requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4294-4\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4294\" type=\"checkbox\" name=\"vfb-field-4294[4]\" value=\"1\">Continuing Education requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4294-5\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4294\" type=\"checkbox\" name=\"vfb-field-4294[5]\" value=\"1\">License or certification renewal requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4294-6\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4294\" type=\"checkbox\" name=\"vfb-field-4294[6]\" value=\"1\">Other agency requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4294-7\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4294\" type=\"checkbox\" name=\"vfb-field-4294[7]\" value=\"1\">Other reason<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4295\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4295\" class=\"vfb-control-label\">Name of agency requiring completion <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-help-block\">Please provide the name of the agency requiring completion of the course. If it is for a different reason, please answer, \"Not applicable.\"<\/span><input id=\"vfb-field-4295\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4295\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4296\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4296\" class=\"vfb-control-label\">Do you hold professional healthcare and\/or counseling Licenses \/ Certifications?<\/label><div><span class=\"vfb-help-block\">If applicable, please identify professional healthcare license(s) and\/or certification(s) that you currently hold, and include the name(s) of the agency or agencies.\r\n<\/span><input id=\"vfb-field-4296\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-4296\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-checkbox\" id=\"vfbField4297\"><label for=\"vfb-field-4297\" class=\"vfb-control-label\">Do you hold internationally-awarded Breining Institute credentials?<\/label><div><span class=\"vfb-help-block\">If you have earned one or more internationally-awarded credentials from Breining Institute, please select which ones below (select all that apply):<\/span><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[0]\" value=\"1\">Registered Addiction Specialist (RAS)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-1\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[1]\" value=\"1\">Advanced RAS - Level II (RAS II)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-2\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[2]\" value=\"1\">Advanced RAS - Level III (RAS III)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-3\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[3]\" value=\"1\">Masters Level - RAS (M-RAS)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-4\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[4]\" value=\"1\">Clinical Supervisor Credential (CSC)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-5\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[5]\" value=\"1\">Master Counselor in Addictions (MCA)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-6\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[6]\" value=\"1\">Certified Women's Treatment Specialist (CWTS)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-7\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[7]\" value=\"1\">Medication-Assisted Treatment Counselor (MATC)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-8\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[8]\" value=\"1\">Forensic Addictions Counselor (FAC)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-9\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[9]\" value=\"1\">Certified Co-occurring Disorders Specialist (CCDS)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-10\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[10]\" value=\"1\">Certified Case Manager Interventionist - Associate Level (CCMI-A)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-11\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[11]\" value=\"1\">Certified Case Manager Interventionist (CCMI)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4297-12\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4297\" type=\"checkbox\" name=\"vfb-field-4297[12]\" value=\"1\">Certified Case Manager Interventionist - Masters Level (CCMI-M)<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><\/section><section class=\"vfb-page-section\"><h3 class=\"vfb-page-title\">Course Evaluation<\/h3><div class=\"vfb-col-12 vfb-fieldType-page-break\" id=\"vfbField4298\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-form-group vfb-col-12\"><div><div class=\"\"><\/div><span class=\"vfb-help-block\"><h2><span style=\"color: #008000;\">Course Evaluation<\/span><\/h2><\/span><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField4299\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4300\"><label for=\"vfb-field-4300\" class=\"vfb-control-label\">Did the course cover the content you were expecting? <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4300-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4300\" value=\"Yes\">Yes<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4300-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4300\" value=\"It covered some of the information expected\">It covered some of the information expected<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4300-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4300\" value=\"No\">No<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4300-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4300\" value=\"Other\">Other<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4301\"><label for=\"vfb-field-4301\" class=\"vfb-control-label\">Rate the overall value of the information presented in this course. <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4301-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4301\" value=\"Extremely valuable\">Extremely valuable<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4301-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4301\" value=\"Somewhat valuable\">Somewhat valuable<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4301-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4301\" value=\"Not very valuable\">Not very valuable<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4301-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4301\" value=\"Other\">Other<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4302\"><label for=\"vfb-field-4302\" class=\"vfb-control-label\">Rate your overall experience of taking this online course. <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4302-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4302\" value=\"5 stars: Excellent\">5 stars: Excellent<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4302-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4302\" value=\"4 stars: Very good\">4 stars: Very good<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4302-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4302\" value=\"3 stars: Average\">3 stars: Average<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4302-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4302\" value=\"2 stars: Below average\">2 stars: Below average<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4302-4\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4302\" value=\"1 star: Not good\">1 star: Not good<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField4303\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4303\" class=\"vfb-control-label\">Do you have any comments or suggestions about this course?<\/label><div><span class=\"vfb-help-block\">Your evaluation of this online course is important to Breining Institute. We will use your evaluation to improve our future offerings of this and other online education courses. <\/span><textarea id=\"vfb-field-4303\" class=\"vfb-form-control\" placeholder=\"\" rows=\"10\" name=\"vfb-field-4303\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-checkbox\" id=\"vfbField4304\"><label for=\"vfb-field-4304\" class=\"vfb-control-label\">How did you find out about this course? <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4304-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4304\" required=\"required\" type=\"checkbox\" name=\"vfb-field-4304[0]\" value=\"1\">Friend, colleague or co-worker<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4304-1\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4304\" type=\"checkbox\" name=\"vfb-field-4304[1]\" value=\"1\">Social media (such as Facebook, LinkedIn)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4304-2\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4304\" type=\"checkbox\" name=\"vfb-field-4304[2]\" value=\"1\">Program Supervisor or Manager<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4304-3\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4304\" type=\"checkbox\" name=\"vfb-field-4304[3]\" value=\"1\">Licensing or Certification agency<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4304-4\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4304\" type=\"checkbox\" name=\"vfb-field-4304[4]\" value=\"1\">Other<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4305\"><label for=\"vfb-field-4305\" class=\"vfb-control-label\">Years in AOD\/SUD and\/or Healthcare Profession <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-help-block\">How long have you been providing professional AOD\/SUD counseling services, or have been in the healthcare profession?<\/span><div class=\"vfb-radio\"><label><input id=\"vfb-field-4305-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4305\" value=\"Less than 1 year\">Less than 1 year<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4305-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4305\" value=\"1 - 3 years\">1 - 3 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4305-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4305\" value=\"3 - 5 years\">3 - 5 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4305-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4305\" value=\"5 - 10 years\">5 - 10 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4305-4\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4305\" value=\"10 - 15 years\">10 - 15 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4305-5\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4305\" value=\"15 - 20 years\">15 - 20 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4305-6\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4305\" value=\"More than 20 years\">More than 20 years<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><\/section><section class=\"vfb-page-section\"><h3 class=\"vfb-page-title\">Answer Sheet<\/h3><div class=\"vfb-col-12 vfb-fieldType-page-break\" id=\"vfbField4306\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField4307\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4307\" class=\"vfb-control-label\"><\/label><div class=\"\"><h4>Your next step is to complete the online ANSWER SHEET.<\/h4>\n<h4>Select the \u201cSubmit\u201d button below <span style=\"color: #ff0000;\">when you are ready to complete the online Answer Sheet.<\/span><\/h4>\n<\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-captcha\" id=\"vfbField4308\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4308\" class=\"vfb-control-label\">Captcha <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"g-recaptcha\" data-sitekey=\"6LdWgN0UAAAAAM_hb1SqmzT2DP4J1X289K2epOVA\"><\/div><input type=\"hidden\" name=\"_vfb_recaptcha_enabled\" value=\"1\" id=\"\"><div class=\"vfb-has-error\" id=\"vfb-recaptcha-error\"><span class=\"vfb-help-block\">reCAPTCHA is required.<\/span><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-submit\" id=\"vfbField4309\"><button id=\"vfb-field-4309\" class=\" btn btn-primary\" placeholder=\"\" type=\"submit\" name=\"_vfb-submit\">Submit<\/button><\/div><div class=\"vfb-clearfix\"><\/div><\/section><\/form>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-42740","page","type-page","status-publish","czr-hentry"],"_links":{"self":[{"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/pages\/42740","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/comments?post=42740"}],"version-history":[{"count":2,"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/pages\/42740\/revisions"}],"predecessor-version":[{"id":42764,"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/pages\/42740\/revisions\/42764"}],"wp:attachment":[{"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/media?parent=42740"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}