{"id":42748,"date":"2026-09-21T10:14:32","date_gmt":"2026-09-21T17:14:32","guid":{"rendered":"https:\/\/www.breining.edu\/?page_id=42748"},"modified":"2026-09-23T13:29:31","modified_gmt":"2026-09-23T20:29:31","slug":"course-no-ee26-07-student-information","status":"publish","type":"page","link":"https:\/\/www.breining.edu\/index.php\/course-no-ee26-07-student-information\/","title":{"rendered":"Course No. EE26-07: STUDENT INFORMATION"},"content":{"rendered":"<form method=\"post\" enctype=\"multipart\/form-data\" id=\"vfbp-form-142\" 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-142\" value=\"1791667759\" id=\"\"><input type=\"hidden\" name=\"_vfb-form-id\" value=\"142\" id=\"\"><section class=\"vfb-page-section\"><h3 class=\"vfb-page-title\">Instructions<\/h3><div class=\"vfb-col-12 vfb-fieldType-page-break\" id=\"vfbField4397\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField4398\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4398\" 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=\"vfbField4399\"><\/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=\"vfbField4400\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4401\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4401\" class=\"vfb-control-label\">Full Name: <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4401\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4401\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4402\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4402\" class=\"vfb-control-label\">Street Address <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4402\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4402\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4403\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4403\" class=\"vfb-control-label\">City <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4403\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4403\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4404\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4404\" class=\"vfb-control-label\">State or Province <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4404\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4404\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4405\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4405\" class=\"vfb-control-label\">ZIP Code (or Postal Code) <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4405\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4405\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField4406\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4406\" 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-4406\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"email\" name=\"vfb-field-4406\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField4407\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4407\" class=\"vfb-control-label\">Confirm Email Address: <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-4407\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" data-vfb-equalto=\"#vfb-field-4406\" type=\"email\" name=\"vfb-field-4407\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4408\"><label for=\"vfb-field-4408\" 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-4408-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4408\" value=\"Desktop computer\">Desktop computer<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4408-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4408\" value=\"Laptop computer\">Laptop computer<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4408-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4408\" value=\"Tablet\">Tablet<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4408-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4408\" value=\"Smart phone\">Smart phone<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4408-4\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4408\" value=\"Other\">Other<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4408-5\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4408\" 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=\"vfbField4409\"><label for=\"vfb-field-4409\" 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-4409-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4409\" value=\"Google Chrome\">Google Chrome<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4409-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4409\" value=\"Safari\">Safari<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4409-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4409\" value=\"Microsoft Edge\">Microsoft Edge<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4409-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4409\" value=\"Firefox\">Firefox<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4409-4\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4409\" value=\"Opera\">Opera<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4409-5\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4409\" value=\"Internet Explorer\">Internet Explorer<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4409-6\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4409\" value=\"Brave\">Brave<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4409-7\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4409\" value=\"Other\">Other<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4409-8\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4409\" 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=\"vfbField4410\"><label for=\"vfb-field-4410\" 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-4410-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4410\" required=\"required\" type=\"checkbox\" name=\"vfb-field-4410[0]\" value=\"1\">Licensing agency requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4410-1\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4410\" type=\"checkbox\" name=\"vfb-field-4410[1]\" value=\"1\">Certification agency requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4410-2\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4410\" type=\"checkbox\" name=\"vfb-field-4410[2]\" value=\"1\">Registration requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4410-3\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4410\" type=\"checkbox\" name=\"vfb-field-4410[3]\" value=\"1\">Employer requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4410-4\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4410\" type=\"checkbox\" name=\"vfb-field-4410[4]\" value=\"1\">Continuing Education requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4410-5\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4410\" type=\"checkbox\" name=\"vfb-field-4410[5]\" value=\"1\">License or certification renewal requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4410-6\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4410\" type=\"checkbox\" name=\"vfb-field-4410[6]\" value=\"1\">Other agency requirement<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4410-7\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4410\" type=\"checkbox\" name=\"vfb-field-4410[7]\" value=\"1\">Other reason<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4411\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4411\" 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-4411\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-4411\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField4412\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4412\" 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-4412\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-4412\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-checkbox\" id=\"vfbField4413\"><label for=\"vfb-field-4413\" 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-4413-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[0]\" value=\"1\">Registered Addiction Specialist (RAS)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-1\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[1]\" value=\"1\">Advanced RAS - Level II (RAS II)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-2\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[2]\" value=\"1\">Advanced RAS - Level III (RAS III)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-3\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[3]\" value=\"1\">Masters Level - RAS (M-RAS)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-4\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[4]\" value=\"1\">Clinical Supervisor Credential (CSC)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-5\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[5]\" value=\"1\">Master Counselor in Addictions (MCA)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-6\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[6]\" value=\"1\">Certified Women's Treatment Specialist (CWTS)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-7\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[7]\" value=\"1\">Medication-Assisted Treatment Counselor (MATC)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-8\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[8]\" value=\"1\">Forensic Addictions Counselor (FAC)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-9\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[9]\" value=\"1\">Certified Co-occurring Disorders Specialist (CCDS)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-10\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[10]\" value=\"1\">Certified Case Manager Interventionist - Associate Level (CCMI-A)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-11\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[11]\" value=\"1\">Certified Case Manager Interventionist (CCMI)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4413-12\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4413\" type=\"checkbox\" name=\"vfb-field-4413[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=\"vfbField4414\"><\/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=\"vfbField4415\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4416\"><label for=\"vfb-field-4416\" 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-4416-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4416\" value=\"Yes\">Yes<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4416-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4416\" 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-4416-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4416\" value=\"No\">No<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4416-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4416\" value=\"Other\">Other<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4417\"><label for=\"vfb-field-4417\" 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-4417-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4417\" value=\"Extremely valuable\">Extremely valuable<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4417-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4417\" value=\"Somewhat valuable\">Somewhat valuable<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4417-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4417\" value=\"Not very valuable\">Not very valuable<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4417-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4417\" value=\"Other\">Other<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4418\"><label for=\"vfb-field-4418\" 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-4418-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4418\" value=\"5 stars: Excellent\">5 stars: Excellent<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4418-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4418\" value=\"4 stars: Very good\">4 stars: Very good<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4418-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4418\" value=\"3 stars: Average\">3 stars: Average<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4418-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4418\" value=\"2 stars: Below average\">2 stars: Below average<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4418-4\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4418\" 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=\"vfbField4419\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4419\" 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-4419\" class=\"vfb-form-control\" placeholder=\"\" rows=\"10\" name=\"vfb-field-4419\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-checkbox\" id=\"vfbField4420\"><label for=\"vfb-field-4420\" 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-4420-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4420\" required=\"required\" type=\"checkbox\" name=\"vfb-field-4420[0]\" value=\"1\">Friend, colleague or co-worker<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4420-1\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4420\" type=\"checkbox\" name=\"vfb-field-4420[1]\" value=\"1\">Social media (such as Facebook, LinkedIn)<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4420-2\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4420\" type=\"checkbox\" name=\"vfb-field-4420[2]\" value=\"1\">Program Supervisor or Manager<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4420-3\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4420\" type=\"checkbox\" name=\"vfb-field-4420[3]\" value=\"1\">Licensing or Certification agency<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-4420-4\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-4420\" type=\"checkbox\" name=\"vfb-field-4420[4]\" value=\"1\">Other<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField4421\"><label for=\"vfb-field-4421\" 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-4421-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4421\" value=\"Less than 1 year\">Less than 1 year<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4421-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4421\" value=\"1 - 3 years\">1 - 3 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4421-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4421\" value=\"3 - 5 years\">3 - 5 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4421-3\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4421\" value=\"5 - 10 years\">5 - 10 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4421-4\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4421\" value=\"10 - 15 years\">10 - 15 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4421-5\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4421\" value=\"15 - 20 years\">15 - 20 years<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-4421-6\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-4421\" 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=\"vfbField4422\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField4423\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4423\" 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=\"vfbField4424\"><div class=\"vfb-form-group\"><label for=\"vfb-field-4424\" 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=\"vfbField4425\"><button id=\"vfb-field-4425\" 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-42748","page","type-page","status-publish","czr-hentry"],"_links":{"self":[{"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/pages\/42748","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=42748"}],"version-history":[{"count":2,"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/pages\/42748\/revisions"}],"predecessor-version":[{"id":42809,"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/pages\/42748\/revisions\/42809"}],"wp:attachment":[{"href":"https:\/\/www.breining.edu\/index.php\/wp-json\/wp\/v2\/media?parent=42748"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}