| Model Instance Name: FEMA ReadyGov | ||||||||||||||||
| underlined & italicized: RE-ORDER | ||||||||||||||||
| MID: A8loVYAp1BsIwlkMFx5R8g== | pink: ADDITION | |||||||||||||||
| Date: | 4/13/2011 | blue + -->: REWORDING | ||||||||||||||
| CUSTOM QUESTION LIST | ||||||||||||||||
| QID | Skip Logic Label | Question Text | Answer Choices (limited to 50 characters) |
Skip to | Type (select from list) | Single or Multi | Required Y/N |
Special Instructions | CQ Label | |||||||
| EDO11022 | After visiting this site I feel more prepared for a disaster. (1=Strongly Disagree, 10=Strongly Agree) | 1-Strongly Disagree | Radio button, scale, has don't know | Single | Y | More Prepared for Disaster | ||||||||||
| 2 | ||||||||||||||||
| 3 | ||||||||||||||||
| 4 | ||||||||||||||||
| 5 | ||||||||||||||||
| 6 | ||||||||||||||||
| 7 | ||||||||||||||||
| 8 | ||||||||||||||||
| 9 | ||||||||||||||||
| 10-Strongly Agree | ||||||||||||||||
| DK | ||||||||||||||||
| EDO11023 | How did you hear about the site? (Please select all that apply) | TV Advertising | Radio button, one-up vertical | Single | Y | Skip Logic Group | Heard About | |||||||||
| Print Advertising | ||||||||||||||||
| Outdoor Advertising | Randomize | |||||||||||||||
| Radio Advertising | ||||||||||||||||
| Advertising on Social Networks (Facebook, Twiiter) | ||||||||||||||||
| Internet Advertising | ||||||||||||||||
| Other, please specify: | A | |||||||||||||||
| EDO11024 | A | What other sources brought you to the site? | Text area, no char limit | S | N | Skip Logic Group | Other Heard About Source | |||||||||
| EDO11025 | What media would be effective to notify others during a disaster? (select all that apply) | Cell Phone | Checkbox, one-up vertical | M | Y | Skip Logic Group | Media to Notify Others | |||||||||
| Randomize | ||||||||||||||||
| Social Networking Sites (facebook) | ||||||||||||||||
| Other, please specify: | A | |||||||||||||||
| EDO11026 | A | What other media would be effective to inform others about a disaster? | Text area, no char limit | S | N | Skip Logic Group | Other Effective Media to Notify Others | |||||||||
| EDO11027 | What media do you currently use to respond to or notify others of disasters? (select all that apply) | Cell Phone | Checkbox, one-up vertical | M | Y | Skip Logic Group | Means Currently Use to Notify Others | |||||||||
| Randomize | ||||||||||||||||
| Social Networking Sites (facebook) | ||||||||||||||||
| Other, please specify | A | |||||||||||||||
| EDO11028 | A | What other media would be effective to inform others about preparedness information? | Text area, no char limit | S | N | Skip Logic Group | Other Means to Notify Others | |||||||||
| EDO11029 | What best describes your role when coming to this site? | Parent | Radio button, one-up vertical | S | Y | Role | ||||||||||
| Home (Property) Owner | Skip Logic Group | |||||||||||||||
| First Responder | ||||||||||||||||
| Emergency Managers and Personnel | ||||||||||||||||
| Private Sector (business, small business, contractor, vendor) | ||||||||||||||||
| Government official or employee | ||||||||||||||||
| Media | ||||||||||||||||
| Student or educator | ||||||||||||||||
| Other, please specify | A | |||||||||||||||
| EDO11030 | A | If you answered "other" above, please specify other role. | Text area, no char limit | S | N | Skip Logic Group | Other Role | |||||||||
| EDO11031 | What was your primary reason for visiting Ready.gov today? | Get an emergency supply kit | Radio button, one-up vertical | S | Y | Skip Logic Group | Reason for Visit | |||||||||
| Make a family emergency plan | ||||||||||||||||
| Learn more about the potential emergencies that could happen where I live and the appropriate way to respond to them. |
Randomize | |||||||||||||||
| Learn about which disasters are likely to happen in my area | ||||||||||||||||
| Prepare employees for an emergency | ||||||||||||||||
| Just browsing/not looking for anything in particular | ||||||||||||||||
| Other (please specify) | A | |||||||||||||||
| EDO11032 | A | If you answered "other" above, please specify other reason for visit. | Text area, no char limit | S | N | Skip Logic Group | Other Reason for Visit | |||||||||
| EDO11033 | Did you find the information you were looking for? | Yes | Radio button, one-up vertical | S | Y | Skip Logic Group | Found Information | |||||||||
| Partially | ||||||||||||||||
| Still looking | ||||||||||||||||
| No (please specify what you were looking for) | A | |||||||||||||||
| EDO11034 | A | Please specify what you were looking for. | Text area, no char limit | S | N | Skip Logic Group | Information Seeking | |||||||||
| EDO11035 | How would you most like to interact with this site? (Please select all that apply) | Bookmark or tag pages (i.e. Digg or Del.icio.us) | Checkbox, one-up vertical | M | Y | Randomize | How Interact with Site | |||||||||
| In social networks | ||||||||||||||||
| By adding comments, ratings, or reviews | ||||||||||||||||
| Reading blogs | ||||||||||||||||
| Contributing to wikis | ||||||||||||||||
| Receiving newsletters/email updates | ||||||||||||||||
| Subscribing to RSS feeds | ||||||||||||||||
| Listening to Podcasts or audio | ||||||||||||||||
| Watching Vodcasts or video | ||||||||||||||||
| Adding a widget or gadget to my personalized page | ||||||||||||||||
| Following a microblog | ||||||||||||||||
| Other (please specify) | A | |||||||||||||||
| EDO11036 | A | If you answered "other" above, please specify other social media interaction | Text area, no char limit | S | N | Skip Logic Group | Other social media interaction | |||||||||
| EDO11037 | If you can make one improvement to this site, what would it be? | Text area, no char limit | S | N | Improvements | |||||||||||
| EDO11038 | Please select your gender: | Male | Radio button, one-up vertical | S | N | Gender | ||||||||||
| Female | ||||||||||||||||
| EDO11039 | Please select your age group: | Under 21 Years Old | Checkbox, one-up vertical | S | N | Age | ||||||||||
| 21-30 Years Old | ||||||||||||||||
| 31-40 Years Old | ||||||||||||||||
| 41-50 Years Old | ||||||||||||||||
| 51-60 Years Old | ||||||||||||||||
| 61-70 Years Old | ||||||||||||||||
| Over 70 Years Old | ||||||||||||||||
| File Type | application/vnd.ms-excel |
| File Title | Questionnaire Production Guidelines_Template |
| Author | Professional Services |
| Last Modified By | edwin.oslan |
| File Modified | 2011-04-21 |
| File Created | 2001-08-03 |