Form #2 Monthly E-mail Check-in Text

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Attachment A - Monthly Email Check-in Text

Customer Satisfaction with HIE Evaluation Toolkit

OMB: 0935-0179

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AShape1 ttachment A: Monthly E-mail Check-in Text


[NOTE: This is to be sent via e-mail to participants who have previously agreed to provide feedback about the HIE Evaluation Toolkit. The goal of the monthly check-in is to monitor participant progress and detect drop-outs early.]


Subject Line: Status Update – Customer Satisfaction with HIE Evaluation Toolkit Project

Dear [INSERT RESPONDENT NAME HERE],

You are receiving this e-mail because you agreed to participate in the AHRQ Customer Satisfaction with the Health Information Exchange (HIE) Evaluation Toolkit project. As we explained during our first phone call, we are contacting you monthly to get an update on your progress in developing your evaluation plan, and use of the toolkit.

Please answer the following questions. As possible, please include details in your response:


  1. Have you used the HIE Evaluation Toolkit since our last contact on [ADD DATE] for your evaluation plan development? Why or why not? In what manner?

  2. Are you still actively developing an HIE evaluation plan? If no, please indicate the following:

  1. Plan is complete;

  2. Work on the developing the plan is delayed, but will continue through April 2013;

  3. Work on the developing the plan has stopped, and is not expected to resume between now and April 2013; or

  4. You are no longer involved in the formulation of the plan.

If you have any questions or concerns, please feel free to contact me. My contact information is listed below. Thank you again for your participation and interest.

Sincerely,

Mary Crimmins, MA

Westat HIE Evaluation Toolkit Project Director

[email protected]

(240) 314-5880


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