Attachment 3.
Epi-X Customer Survey
FORM APPROVED
OMB No. 0920-0636
EXP DATE MM/DD/20YY
Public reporting burden of this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, GA 30333; ATTN: PRA (0920-0636).
Epi- X Customer Survey
On <date>, Epi-X sent an emergency notification. To help CDC improve the rapid notification system, we need your feedback.
How did you first receive the emergency notification?
Work telephone
Cell phone
Home phone
Voice mail
Pager
From a colleague
Did not learn of it
Other (e.g., answering service)
If “Other,” explain how.
Where were you when you first received the emergency notification?
At work
At home
In transit
Did not learn of it
Other
If “Other,” explain where.
How did you respond to the emergency notification? Select all that apply.
Logged on to Epi-X
Called a telephone number from a numeric pager message
Called a colleague
Did not respond
If you did not respond, why not?
Other
If “Other,” explain how.
If you received the emergency notification by numeric pager, you should have received a telephone number to call. If you called the telephone number provided, was your call answered on the first attempt?
I did not receive a numeric pager message.
The call was answered the first time.
I had to call two or more times.
The call was not answered.
I did not call back to the notification system.
Comment on your experience.
From which computers or devices do you routinely access Epi-X?
Work computer
Home computer
Laptop
Mobile device (e.g., BlackBerry)
If “Mobile device,” specify which mobile device.
Other
If “Other,” explain which computer.
Do you have other computers from which you want to access Epi-X?
Yes
No
What is your opinion of the Epi-X emergency notification system?
Very Satisfactory
Satisfactory
No opinion
Unsatisfactory
Very Unsatisfactory
Explain your answer and/or suggest improvements.
What is your opinion of the voice messaging system?
Very Satisfactory
Satisfactory
No opinion
Unsatisfactory
Very Unsatisfactory
Explain your answer and/or suggest improvements.
Do you have a mobile device (e.g., BlackBerry, IPhone, SmartPhone) from which you want to access Epi-X?
Yes
No
If “Yes,” what type of mobile device do you have?
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | azf2 |
| File Modified | 0000-00-00 |
| File Created | 2021-02-01 |