Form Approved
OMB No. 0920-0753
Exp. Date: xx/xx/xxxx
Attachment E: Interactive Voice Response Survey for Callers (English)
Brief Interactive Voice Response Survey
We invite you to participate in a quick survey which will help us to better meet the needs of callers. If you would like to participate, press 1. If not, press 2.
(If the caller does not consent, they will hear a concluding message that says)
Thank you for calling CDC-INFO. Goodbye.
(If the caller consents, they will continue with the IVR survey):
Thank you for participating in CDC-INFO’s satisfaction survey. We expect it to take 4 minutes to complete the survey. For each question, you will be given a list of responses. Please listen to all responses before selecting your answer. Then press the appropriate key on your telephone keypad.
(The options repeat automatically if the caller does not respond)
Was this your first call to CDC-INFO?
If yes, press 1.
If no, press 2.
How well did the information provided by CDC-INFO answer your questions?
If very well, press 1.
If fairly well, press 2.
If not very well, press 3.
If not at all well, press 4.
Did the information you received answer your questions?
If yes, press 1.
If no, press 2.
How well did the representative you talked to understand what you needed?
If the representative clearly understood your needs, press 1.
If the representative somewhat understood your needs, press 2.
If the representative did not understand your needs very well, press 3.
If the representative did not understand your needs at all, press 4.
Public reporting burden of this collection of information is estimated to average of 4 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0753) |
How quickly did the representative you talked to respond to your questions?
If the representative was very quick in responding to your questions, press 1.
If the representative was fairly quick in responding to your questions, press 2.
If the representative was not very quick in responding to your questions, press 3.
If the representative was very slow or could not respond to your questions, press 4.
How satisfied are you with the services CDC-INFO provided?
If very satisfied, press 1.
If more satisfied than dissatisfied, press 2.
If more dissatisfied than satisfied, press 3.
If very dissatisfied, press 4.
The last few questions will help CDC INFO learn more about the people we’re reaching with our service.
Are you male or female?
For male, press 1.
For female, press 2.
How old are you?
If you are age 19 or under, press 1.
If you are 20-34 years old, press 2
If you are 35-49 years old, press 3.
If you are 50-64 years old, press 4.
If you are age 65 or older, press 5.
What race or ethnicity do you identify with most?
If you are Hispanic or Latino, press 1.
If you are Black or African American, press 2.
If you are White, press 3.
If you are Asian, press 4.
If you are American Indian or Alaska Native, press 5.
If you are Native Hawaiian or Other Pacific Islander, press 6.
Do you identify with any other race or ethnicity?
If yes, press 1. (continue to item 11)
If no, press 2. (skip to item 12)
What other race or ethnicity do you identify with?
If you are Hispanic or Latino, press 1.
If you are Black or African American, press 2.
If you are White, press 3.
If you are Asian, press 4.
If you are American Indian or Alaska Native, press 5.
If you are Native Hawaiian or Other Pacific Islander, press 6.
| File Type | application/msword |
| Author | imn1 |
| Last Modified By | ziy6 |
| File Modified | 2010-10-14 |
| File Created | 2010-10-14 |