Various Demographic Area Pretesting Activities

Attachment D

Questionnaire for User Interaction Satisfaction (QUIS)

Please circle the numbers that most appropriately reflect your impressions about using

the ACS Online Survey.

1. Overall reaction to the Web Survey: Dissatisfied Satisfied

1 2 3 4 5 6 7 8 9 10 not applicable

2. Overall Appearance: Dissatisfied Satisfied

1 2 3 4 5 6 7 8 9 10 not applicable

3. Use of terminology throughout the survey: Dissatisfied Satisfied

1 2 3 4 5 6 7 8 9 10 not applicable

4. Instructions displayed on the screens: Dissatisfied Satisfied

1 2 3 4 5 6 7 8 9 10 not applicable

5. Ease with which you could move: Dissatisfied Satisfied

1 2 3 4 5 6 7 8 9 10 not applicable

6. Knowing where you were in the form: Dissatisfied Satisfied

1 2 3 4 5 6 7 8 9 10 not applicable

7. Organization of question, instructions, Dissatisfied Satisfied

and response categories in the survey: 1 2 3 4 5 6 7 8 9 10 not applicable

8. Forward navigation: Dissatisfied Satisfied

1 2 3 4 5 6 7 8 9 10 not applicable

9. Overall experience of completing the survey: Dissatisfied Satisfied

1 2 3 4 5 6 7 8 9 10 not applicable

10. Additional Comments:

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