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red & strike-through: DELETE |
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| #REF! |
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underlined & italicized: RE-ORDER |
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pink: ADDITION |
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| Date: |
Nov. 23, 2009 |
blue + -->: REWORDING |
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| #REF! |
| 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 |
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Which of the following best describes you? |
Academic/Researcher |
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Radio - one up vertical |
single |
Y |
Skip Logic Group |
Best describes you |
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General Public |
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Government employee (State & Local) |
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Government employee (Federal) |
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Clinician/Healthcare Provider |
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Health IT Professional |
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Commercial Vendor |
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Media |
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Other, please specify: |
A |
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A |
Other role |
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Text area, no char limit |
single |
No |
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What is your primary reason for visiting this site today? |
Find funding opportunities |
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Radio - one up vertical |
single |
Y |
Skip Logic Group |
Reason for visit |
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Find FACA meeting materials |
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Learn about Meaningful Use |
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Join the NHIN |
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Read use cases |
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Learn about Health IT |
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Read Dr. Blumenthal's updates |
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Just browsing |
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Contact ONC (I would move this to the end) |
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Other, please specify: |
A |
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A |
Other reason for visiting site: |
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single |
No |
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Other reason for visit |
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Did you find what you were looking for ? |
I wasn’t looking for anything in particular |
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Radio - one up vertical |
single |
Y |
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Did you find it |
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Yes |
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No |
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How often do you visit this site ? |
First time |
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Radio - one up vertical |
single |
Y |
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Frequency of visits |
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Daily |
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About once a week |
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About once a month |
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Every six months or less |
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How do you currently receive Health IT information from sources other than ONC? (Please select all that apply) |
Social networks (i.e., Facebook, LinkedIn) |
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Checkbox, one-up vertical |
multi |
y |
Skip Logic Group |
Receive other HealthIT info via |
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Reading blogs |
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Following a microblog (i.e., Twitter) |
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Contributing to wikis |
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Receiving newsletters/email updates/RSS feeds |
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Listening/Viewing Podcasts or Vodcasts |
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None |
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Other, please specify: |
A |
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A |
Other, I currently receive Health IT information via: |
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Text area, no char limit |
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Other, receive healthIT info via |
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Are you interested in participating in usability testing for our site? |
No |
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Radio - one up vertical |
single |
Y |
OPS Group |
Interest in usability testing |
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Yes, my email address is |
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A |
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A |
Email addresses for visitors interested in participating in usability testing |
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Text field, <100 char |
single |
N |
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Email for usability testing |
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If you could change one thing about the site, what would it be? |
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Text area, no char limit |
single |
N |
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Change one thing |
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| Types |
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Instructions |
| Text field, <100 char |
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Randomize |
| Text area, no char limit |
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Shared |
| Drop down, select one |
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OPS Group |
| Radio button, one-up vertical |
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Matrix Group |
| Radio button, two-up vertical |
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Rank Group |
| Radio button, three-up vertical |
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Comparative Matrix Group |
| Radio button, scale, has don't know |
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Skip Logic Group |
| Radio button, scale, no don't know |
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Multiple Lists Group |
| Checkbox, one-up vertical |
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Anchor Answer Choice |
| Checkbox, two-up vertical |
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Partitioned |
| Checkbox, three-up vertical |
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Adjust Template/Style Sheet |