333 CQs 333 CQs 6-8-10

American Customer Satisfaction Index (ACSI) E-Government Website Customer Satisfaction Surveys

2010 333 CQs for OMB 6-8-2010 to 7-6-2010.xlsx

Previously Cleared ICs from prior Generic ICR

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf
Measures Name/Client name (CDs and Answer choices)






















































































































CMS - Pinnacle BSI







































B What information were you unable to find?


Text area, no char limit Single Y Skip Logic Group





































































CMS Palmetto GBA J1 MAC














































































EDO03184
What is your primary reason for visiting this site today? EDO03184A001 Download forms
Radio buttons Single Y OPS Group
































EDO03184A002 Learn of, or register for, workshops, seminars or other training events





































EDO03184A003 Find contact information





































EDO03184A004 Find general Medicare program information





































EDO03184A005 Research a specific question on Medicare policy or billing





































EDO03184A006 Access claim status and/or beneficiary eligibility





































EDO03184A007 Find information on fees or fee schedules





































EDO03184A008 Find out about a Local Coverage Determination (LCD)





































EDO03184A009 Read Medicare publications such as newsletters, articles, etc.





































EDO03184A010 Find enrollment information





































EDO03184A011 Take an on-line training course





































EDO03184A012 Other (please specify) SKIP B

































EDO03185 SKIP B Other - primary reason?


Text field, <100 char Single No OPS Group





































































FBI Internet Satisfaction Survey














































































EDO03215 H Which of the following explains why you are not watching videos on the FBI site? (Please select all that apply) EDO03215A001 Too long to watch
Radio button, one-up vertical Multi Y Skip Logic Not Video































EDO03215A002 Not interesting





































EDO03215A003 Too small on my screen





































EDO03215A004 Do not work on my computer





































EDO03215A005 Do not want to click through to another page to play the video





































EDO03215A006 Did not know where there were videos on the site





































EDO03215A007 Other (please specify) A

































EDO03216 A What other reasons don't you watch videos on the FBI site?


Text field, <100 char
N open end





































































FDA Satisfaction Survey






































EDO03237
For this visit to the FDA site, which of the following roles best describes you? EDO03237A001 Regulated industry A Radio Button One Up Vertical Single Y OPS Group
































EDO03237A002 Consumer





































EDO03237A003 Scientist, researcher





































EDO03237A004 Patient





































EDO03237A005 Caregiver, friend, family member of a person interested in health issues





































EDO03237A006 Physician





































EDO03237A007 Nurse, physician's assistant, nurse practitioner





































EDO03237A008 Pharmacist





































EDO03237A009 Other type of healthcare provider





































EDO03237A010 State or local public health professional





































EDO03237A011 Not-for-profit public health professional





































EDO03237A012 Consultant





































EDO03237A013 Attorney/Legal Counsel





































EDO03237A014 Educator, professor, teacher





































EDO03237A015 Student





































EDO03237A016 Journalist/Media





































EDO03237A017 Policymaker, legislator, staff





































EDO03237A018 FDA grantee





































EDO03237A019 FDA employee





































EDO03237A020 First responder





































EDO03237A021 Other, please specify: C

































EDO03238 A Which of the following best describes your company/organization? EDO03238A001 Manufacturer B




































EDO03238A002 Distributor B




































EDO03238A003 Importer B




































EDO03238A004 Other B

































EDO03239 B Which of the following industry categories is your company/organization a part of? (Please select all that apply) EDO03239A001 Drugs & Biologics (Human)





































EDO03239A002 Drugs & Biologics (Animal)





































EDO03239A003 Medical Devices





































EDO03239A004 Food





































EDO03239A005 Dietary Supplements





































EDO03239A006 Cosmetics





































EDO03239A007 Tobacco


































EDO03240
While on the FDA.gov site, please describe how you reached the page you were on before taking this survey:


Text area, no char limit Single Y
Open Navigate




























EDO03241 A What were you hoping to find on the FDA Basics area of the site?


Text area, no char limit Single Y Skip Logic Group lookingforBasics




























EDO03242 A How did you hear about FDA Basics?


Text area, no char limit Single Y Skip Logic Group HearaboutBasics




























EDO03243
If you could make one improvement to the site what would that be?


Text area, no char limit Open N
One Improvement




































































NIH genome.gov














































































EDO03285
What best describes you? EDO03285A001 Educator

Single Y Skip Logic Group
































EDO03285A002 Student (high school/college) A




































EDO03285A003 Pursing a graduate degree (Master’s, PhD, and/or MD)





































EDO03285A004 Researcher B




































EDO03285A005 Health care provider





































EDO03285A006 Other C

































EDO03286 A Which type of student are you? EDO03286A001 High school

Single Y

































EDO03286A002 Undergraduate


































EDO03287 B Which type of researcher are you? EDO03287A001 Researcher at NIH

Single Y

































EDO03287A002 Research not at NIH


































EDO03288 C Which of the following specifically describes you? EDO03288A001 Patient

Single Y

































EDO03288A002 Scientific administrator





































EDO03288A003 Author





































EDO03288A004 Job/Career seeker





































EDO03288A005 Reporter/member of a news organizations





































EDO03288A006 Policy maker/writer





































EDO03288A007 Other (please specify) D

































EDO03289 D Please describe your role in coming to this site.




N






























EDO03290 B Which of the following did you use to look for information on the site? EDO03290A001 Links across the top of the page
Check box one up vertical Multi Y

































EDO03290A002 Links within the pages





































EDO03290A003 Links along the left side of the page





































EDO03290A004 For You sections





































EDO03290A005 Site map





































EDO03290A006 Staff Directory





































EDO03290A007 Links under see also





































EDO03290A008 Links on the keyword list





































EDO03290A009 Site search BB




































EDO03290A010 Other


































EDO03291 D Which one of the following led you to what you were looking for? EDO03291A001 Links across the top of the page
Radio button, one-up vertical Single Y

































EDO03291A002 Links within the pages





































EDO03291A003 Links along the left side of the page





































EDO03291A004 For You sections





































EDO03291A005 Site map





































EDO03291A006 Staff Directory





































EDO03291A007 Links under see also





































EDO03291A008 Links on the keyword list





































EDO03291A009 Site search





































EDO03291A010 Other


































EDO03292 BB Please indicate how useful the site search was in helping you find what you were looking for.
Very useful
Radio button, one-up vertical Single Y


































Somewhat useful C





































Not at all Useful C

































EDO03293 C What would have made the site search more useful to you?


Open ended
N






































































NPR Customer Satisfaction Survey v2














































































EDO03454
Before taking this survey, had you ever heard of the NPR Shop (online shop that sells official NPR branded merchandise)? EDO03454A001 Yes A Radio button, one-up vertical Single Y Skip Logic NPR Shop_heard































EDO03454A002 No





































EDO03454A003 Don’t know/Not sure


































EDO03455 A Have you ever visited the NPR Shop (online shop that sells official NPR branded merchandise)? EDO03455A001 Yes B Radio button, one-up vertical Single Y Skip Logic NPR Shop_visited































EDO03455A002 No





































EDO03455A003 Don’t know/Not sure


































EDO03456 B In your last visit to the NPR Shop, how well did the NPR Shop meet your expectations? EDO03456A001 1=Poor
radio button, scale, has Don't Know Single Y Skip Logic NPR Shop_opinion































EDO03456A002 2





































EDO03456A003 3





































EDO03456A004 4





































EDO03456A005 5





































EDO03456A006 6





































EDO03456A007 7





































EDO03456A008 8





































EDO03456A009 9





































EDO03456A010 10=Excellent





































EDO03456A011 Don't Know










































































GAO Main Site














































































EDO03461
What GAO site content do you most often seek from a mobile phone/device?


Text area, no char limit Single N






























EDO03457
Have you accessed GAO.gov from a mobile phone/device in the past 30 days? EDO03457A001 Yes A Radio button, one-up vertical Single Y Skip Logic Group
































EDO03457A002 No


































EDO03458 A What type of mobile phone/device did you use: (check one) EDO03458A001 Blackberry
Radio button, one-up vertical Single Y Skip Logic Group
































EDO03458A002 iPhone/iTouch





































EDO03458A003 Droid





































EDO03458A004 Other: please describe B

































EDO03459 B Other: please describe


Text field, <100 char Single N Skip Logic Group





























EDO03460 A Were you successful in viewing the content that you were seeking with your mobile phone/device? EDO03460A001 Yes
Radio button, one-up vertical Single Y Skip Logic Group
































EDO03460A002 No










































































CMS.HHS.gov














































































EDO03462 C Did you know that Medicare.gov contains the information and tools most often needed by beneficiaries? EDO03462A001 Yes
Radio buttons SINGLE Yes Skip Logic Group Benefciary































EDO03462A002 No D
































EDO03462A003 I don't know D





























EDO03463 D Why did you come to the Centers of Medicare and Medicaid Services website?



Text field, <100 char No Skip Logic Group OE_ben_use




































































ASHP














































































EDO03468
Which of the following social media services have you participated with ASHP during the last month? (Select all that apply) EDO03468A001 I do not use ASHP's social media services
Checkbox, one-up vertical Multi Y
Social Media-ASHP































EDO03468A002 Social Networking Sites (ASHP on Facebook, Twitter, LinkedIn, YouTube) B




































EDO03468A003 Blog B




































EDO03468A004 Discussion Board B




































EDO03468A005 RSS News Feeds B




































EDO03468A006 Photo/Video Gallery B




































EDO03468A007 Other, please specify: A, B

































EDO03469 A What other ASHP social media services do you use?


Text area, no char limit


OE_ASHP Social Media




























EDO03470 B How often do you participate with ASHP in social media activities? EDO03470A001 More than once a day
Radio Button One Up Vertical Single Y
SM Frequency-ASHP































EDO03470A002 Daily





































EDO03470A003 About once a week





































EDO03470A004 About once a month





































EDO03470A005 Every 6 months or less










































































IADB






































EDO03483 C I am most interested in the following topic(s): Agriculture
check boxes Multi Y Skip Logic

































Climate change and renewable energy






































Children and youth






































Civil society






































Cities






































Corporate social responsibility






































Cross-border projects






































Culture






































Decentralization






































Demographics






































Democracy






































Economic growth






































Education






































Electricity






































Energy






































Environment






































Finance






































Forestry






































Government






































Gender






































Health






































Highways and roads






































Housing






































Human rights






































Indigenous peoples






































information and communcation technology






































Labor






































Macroeconomics






































Management






































MicroEnterprise






































Migration issues






































Natural disasters






































Neighborhood upgrading






































Oil and mining






































Opportunities for the majority






































Pensions






































Ports and airports






































Pollution






































Poverty reduction






































Private sector






































Public finances






































Public-private partnerships






































Race and ethnicity issues






































Regional integration






































Remittances






































Rural development






































Science and technology






































Small and medium enterprise






































Sports






































Sustainability






































Tourism






































Trade






































Transparency






































Transportation






































Violence and security






































Other (please specify): A


































EDO03484 A What other topics are you interested in?

open ended Single N Skip Logic






























EDO03485
In your opinion, what organization is the leader when it comes to addressing the crisis in Haiti? United Nations
Radio button, one-up vertical Single Y Skip Logic

































World Bank






































Inter-American Development Bank






































USAID






































None






































Other, please specify: A


































EDO03486 A Who do you think is the leader in addressing the Haiti crisis?

open ended Single N Skip Logic






























EDO03487
In your opinion, what organization is a good representative of transparency within government? United Nations
Radio button, one-up vertical Single Y Skip Logic

































World Bank






































Inter-American Development Bank






































USAID






































None






































Other, please specify: A


































EDO03488 A Who do you think represents transparency in government?

open ended Single N Skip Logic






























EDO03489
Please rate your level of trust in the IDB. 1=Not at all Trustworthy
Radio Button Scale, Has Don't Know Single Y


































2






































3






































4






































5






































6






































7






































8






































9






































10=Very Trustworthy






































Don't know



































EDO03490
I can count on the IDB to act in my best interests. 1=Strongly Disagree
Radio Button Scale, Has Don't Know Single Y


































2






































3






































4






































5






































6






































7






































8






































9






































10=Strongly Agree






































Don't know



































EDO03491
I consider the IDB to be trustworthy. 1=Strongly Disagree
Radio Button Scale, Has Don't Know Single Y


































2






































3






































4






































5






































6






































7






































8






































9






































10=Strongly Agree






































Don't know



































EDO03492
The IDB can be trusted to do what is right. 1=Strongly Disagree
Radio Button Scale, Has Don't Know Single Y


































2






































3






































4






































5






































6






































7






































8






































9






































10=Strongly Agree






































Don't know











































































USITC














































































EDO03576 A Other role




































EDO03577
If you could make one improvement to this site, what would it be?

Text area, no char limit
N































EDO03578
From time to time, the USITC likes to reach out to website visitors to follow up regarding their feedback concerning the website. If you are over the age of 18 and would be willing to be contacted in the future, please provide your email address.

Text field, <100 char
N







































































Regulations.gov














































































EDO03616
What brought you to the site today? EDO03616A001 Followed a link from an email
Radio Button One Up Vertical Single Y Skip Logic Learned about site































EDO03616A002 Followed a link/recommendation from a website or news article





































EDO03616A003 Heard about the site from a friend, co-worker, etc.





































EDO03616A004 Did an online search which brought me here





































EDO03616A005 I need this site for my job





































EDO03616A006 Other, please specify D

































EDO03617 D Please specify what brought you to the site today.


Text field, no char limit
N Skip Logic Other Brought to site




























EDO03618 X Please specify what keywords you typed into the search box today.


Text field, no char limit
N Skip Logic Search Keyword




































































FDIC Application V2














































































EDO03712
Please rank the top 3 factors that brought you to the FBI website today. (Rank 1 = Most important)
Rank 1
EDO03712A001 Message/recommendation from a friend on a social network

Drop down, select one Single Y Rank Group































EDO03712A002 Video I saw on YouTube




Randomize































EDO03712A003 Internet blogs or discussion forums





































EDO03712A004 Advertising on social networks (Facebook, My Space, Twitter)





































EDO03712A005 Message directly from the company on a social network





































EDO03712A006 Mobile phone text messages or alerts





































EDO03712A007 Instant Message from a friend or colleague





































EDO03712A008 Familiarity with site/company/brand





































EDO03712A009 Promotional email(s) from the company





































EDO03712A010 Search engeine results





































EDO03712A011 Word of mouth recommendation from someone I know





































EDO03712A012 TV, radio, newspaper, or magazine advertising





































EDO03712A013 Internet advertising





































EDO03712A014 Don't know




Anchor































EDO03712A015 Other




Anchor




























EDO03713
Rank 2 EDO03713A001 Message/recommendation from a friend on a social network

Drop down, select one Single N Rank Group































EDO03713A002 Video I saw on YouTube




Randomize































EDO03713A003 Internet blogs or discussion forums





































EDO03713A004 Advertising on social networks (Facebook, My Space, Twitter)





































EDO03713A005 Message directly from the company on a social network





































EDO03713A006 Mobile phone text messages or alerts





































EDO03713A007 Instant Message from a friend or colleague





































EDO03713A008 Familiarity with site/company/brand





































EDO03713A009 Promotional email(s) from the company





































EDO03713A010 Search engeine results





































EDO03713A011 Word of mouth recommendation from someone I know





































EDO03713A012 TV, radio, newspaper, or magazine advertising





































EDO03713A013 Internet advertising





































EDO03713A014 Don't know




Anchor































EDO03713A015 Other




Anchor




























EDO03714
Rank 3 EDO03714A001 Message/recommendation from a friend on a social network

Drop down, select one Single N Rank Group































EDO03714A002 Video I saw on YouTube




Randomize































EDO03714A003 Internet blogs or discussion forums





































EDO03714A004 Advertising on social networks (Facebook, My Space, Twitter)





































EDO03714A005 Message directly from the company on a social network





































EDO03714A006 Mobile phone text messages or alerts





































EDO03714A007 Instant Message from a friend or colleague





































EDO03714A008 Familiarity with site/company/brand





































EDO03714A009 Promotional email(s) from the company





































EDO03714A010 Search engeine results





































EDO03714A011 Word of mouth recommendation from someone I know





































EDO03714A012 TV, radio, newspaper, or magazine advertising





































EDO03714A013 Internet advertising





































EDO03714A014 Don't know




Anchor































EDO03714A015 Other




Anchor




























EDO03715
If you heard about this website from a social network, please specify the site (i.e. Facebook, Twitter)



Text area, no char limit
N





































































FDIC Main v2






































EDO03716
Please rank the top 3 factors that brought you to the FBI website today. (Rank 1 = Most important)
Rank 1
EDO03716A001 Message/recommendation from a friend on a social network
Drop down, select one Single Y Rank Group
































EDO03716A002 Video I saw on YouTube





































EDO03716A003 Internet blogs or discussion forums



Adjust Template/Style Sheet
































EDO03716A004 Advertising on social networks (Facebook, My Space, Twitter)



Randomize
































EDO03716A005 Message directly from the company on a social network





































EDO03716A006 Mobile phone text messages or alerts





































EDO03716A007 Instant Message from a friend or colleague





































EDO03716A008 Search engine





































EDO03716A009 Bookmark/Favorite





































EDO03716A010 Another website/link





































EDO03716A011 Brochure





































EDO03716A012 Email from my banker





































EDO03716A013 E-mail from FDIC Online Subscription Service





































EDO03716A014 Newspaper article





































EDO03716A015 Prior experience with FDIC





































EDO03716A016 Business Card





































EDO03716A017 Other government agency





































EDO03716A018 Don't know



Anchor
































EDO03716A019 Other



Anchor





























EDO03717
Rank 2 EDO03717A001 Message/recommendation from a friend on a social network
Drop down, select one Single N Rank Group
































EDO03717A002 Video I saw on YouTube





































EDO03717A003 Internet blogs or discussion forums



Adjust Template/Style Sheet
































EDO03717A004 Advertising on social networks (Facebook, My Space, Twitter)



Randomize
































EDO03717A005 Message directly from the company on a social network





































EDO03717A006 Mobile phone text messages or alerts





































EDO03717A007 Instant Message from a friend or colleague





































EDO03717A008 Search engine





































EDO03717A009 Bookmark/Favorite





































EDO03717A010 Another website/link





































EDO03717A011 Brochure





































EDO03717A012 Email from my banker





































EDO03717A013 E-mail from FDIC Online Subscription Service





































EDO03717A014 Newspaper article





































EDO03717A015 Prior experience with FDIC





































EDO03717A016 Business Card





































EDO03717A017 Other government agency





































EDO03717A018 Don't know



Anchor
































EDO03717A019 Other



Anchor





























EDO03718
Rank 3 EDO03718A001 Message/recommendation from a friend on a social network
Drop down, select one Single N Rank Group
































EDO03718A002 Video I saw on YouTube





































EDO03718A003 Internet blogs or discussion forums



Adjust Template/Style Sheet
































EDO03718A004 Advertising on social networks (Facebook, My Space, Twitter)



Randomize
































EDO03718A005 Message directly from the company on a social network





































EDO03718A006 Mobile phone text messages or alerts





































EDO03718A007 Instant Message from a friend or colleague





































EDO03718A008 Search engine





































EDO03718A009 Bookmark/Favorite





































EDO03718A010 Another website/link





































EDO03718A011 Brochure





































EDO03718A012 Email from my banker





































EDO03718A013 E-mail from FDIC Online Subscription Service





































EDO03718A014 Newspaper article





































EDO03718A015 Prior experience with FDIC





































EDO03718A016 Business Card





































EDO03718A017 Other government agency





































EDO03718A018 Don't know



Anchor
































EDO03718A019 Other



Anchor





























EDO03719
If you heard about this website from a social network, please specify the site (i.e. Facebook, Twitter)


Text area, no char limit
N






























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