547 CQs for OMB started 6-7-2012

Measures Name/Client name (CQs and Answer choices)
AHRQ Quality Measures
How frequently do you visit this site?		This is my first visit
		Every few months or less often
		Once a month
		Once a week
		Several times a week
		Daily/more than once a day
		Don't know
Please indicate your primary reason for visiting the NQMC site today. (Select one.)		Nothing in particular (just browsing)
		Find a specific quality measure(s)
		Review the newest quality measures to keep myself current
		Determine the quality measures available on a specific topic/issue/domain, etc.
		View tutorials on quality measurement
		Access the HHS Measure Inventory (a separate repository within NQMC)
		For academic or health services research
		Other, please specify
Specify your other reason for visiting the NQMC site today.
Did you find the information you were looking for today?		Yes
		Partially
		No
		I was not looking for anything in particular/ I was just browsing
What were you looking for that you were unable to find?
Please describe your experience with navigation (clicking on links and buttons) on this site today.		I had no difficulty browsing on this site.
		Could not navigate back to previous information
		Would often feel lost, not know where I was
		Links did not take me where I expected
		Links/labels are difficult to understand
		Too many links or navigational choices
		Had technical difficulties (e.g. broken link)
		Other, please specify:
What other navigation experience did you have today?
If you used the search/text box feature of the site today to find your information, what was your experience with the search functionality?		I did not encounter any difficulties
		Search results were not helpful
		Returned too many results
		Returned not enough results
		Returned no results
		Returned results that were too similar/redundant
		Results were not relevant to my search
		I did not use the search feature today
		Other search experience
What other search experience did you have today?
How did you look for information on the site today? (Select all that apply.)		Search feature
		Advanced search feature/tool
		Top navigation bar
		Left navigation bar
		Links in the center of the Home page
		Site map
		Other, please specify
Specify other way you looked for information.
Which of the following features are you aware of or have you used? (Select all that apply.)		Keyword search
		Advanced search
		Browse: By Topic
		Browse: By Organization
		Browse: By Domain
		Browse: NQF- Endorsed Measures
		Browse: Measure Initiatives
		Browse: Measures in Progress
		Browse: Measure Index
		Browse: Measure Archive
		Browse: Measures Most Viewed
		Jump To (Measure Summary Tab)
		Measure Classification (Measure Summary Tab)
		Related Content (Measure Summary Tab)
		HHS Measure Inventory
		New This Week Email
		New This Week/Announcements (Home Page)
		Expert Commentaries
		Measure Summary
		Measure Tabular Comparison
		Link to Original Measure Documentation
		None
Is it clear that the HHS Measure Inventory is a separate repository within NQMC?		Yes
		No
How useful do you find the HHS Measure Inventory?		Very useful
		Somewhat useful
		Neutral
		Not useful
		I haven't used the HHS Measure Inventory
How could we improve the HHS Measure Inventory?
How did you learn about NQMC?		Search engine (Google, Yahoo, etc.)
		Link from a related site (NGC, AHRQ, etc.)
		Link from a professional medical society site (AAP, ADA, etc.)
		Link from another health-related site (NLM, Medscape, First Consult, etc.)
		Print media (health care trade publications, medical journals, etc.)
		Link from general media site (USA Today, NY Times, etc.)
		Social media outlet (Facebook, LinkedIn, etc.)
		Colleague or professional association meeting
		Other, please specify
Specify other way you learned about NQMC.
Which of the following best describes you?		Individual Patient/Consumer
		Physician
		Physician Assistant or Nurse Practitioner/Nurse
		Pharmacist or Other Clinical Specialist
		Quality Manager
		Administrator or Manager of Hospital, Health Plan or Medical Group
		Health Services/Clinical Researcher
		Physician/Physician Assistant
		Nurse/Nurse Practitioner
		Other Health Care Provider
		Consumer/General Public
		Health Researcher/Analyst
		Educator/Student
		Health Administrator
		Health Care IT/CDS Implementer
		Health Insurer
		Librarian/Information Specialist
		Media/Press
		Measure Developer
		Public Sector Health Care Purchaser/Employer or Policymaker
		Private Sector Health Care Purchaser or Benefits Manager
		Federal/State/Local Policymaker
		Medical Librarian/Information Specialist or Medical Writer/Editor
		Student (Medical, Nursing or Pharmacy)
		Educator/Teacher/Instructor
		Other, please specify
Specify other role.
Which of the following best represents your primary institutional affiliation?		Hospital
		Ambulatory care facility
		Home care service
		Physician's office
		Rehabilitation facility
		Residential facility (assisted living facility, nursing home)
		Private health plan or health insurance organization
		Health care professional organization
		Government agency (federal, state or local)
		Quality oversight organization
		University or other academic institution
		Consumer or patient advocacy organization
		Other, please specify
Specify other primary institutional affiliation.
How would you describe your level of familiarity with quality measurement?		Very familiar
		Somewhat familiar
		Neutral
		Somewhat unfamiliar
		Very unfamiliar
Please indicate how you or your organization plans to use quality measures. (Select one)		Assess/compare the quality of clinical providers
		Identify/prioritize issues in health care quality
		Determine financial payments to clinical providers
		Evaluate a program/intervention's effectiveness
		For academic research
		For personal research
		Other, please specify
		I do not plan to use quality measures at this time
Specify other plan for using quality measures.
If you plan to measure performance, which of the following settings or types of providers are your most important focus? (Select all that apply.)		I am not planning to measure performance
		Primary care
		Specialty providers
		Hospitals
		Long-term or rehabilitation facilities
		Health insurance plans
		Public health or community-based programs
		Other, please spcify
Specify other important focus.
If you could make one change to the National Quality Measures Clearinghouse™ Web site, what would it be?
OPM Manager
EDO06400	T	What DEPARTMENT OF HEALTH AND HUMAN SERVICES Bureau/Department Component/OPDIV do you work for?		CENTERS FOR DISEASE CONTROL AND PREVENTION		Drop down, select one	Single	Y	Skip Group
				CENTERS FOR MEDICARE & MEDICAID SERVICES
				DEPARTMENT OF HEALTH AND HUMAN SERVICES, ALL OTHER COMPONENTS
				FOOD AND DRUG ADMINISTRATION
				INDIAN HEALTH SERVICE
				IHS – Aberdeen Area
				IHS – Alaska Area
				IHS – Albuquerque Area
				IHS – Bemidji Area
				IHS – Billings Area
				IHS – California Area
				IHS – Headquarters (Rockville, Dallas, Albuquerque, Seattle)
				IHS – Nashville Area
				IHS – Navajo Area
				IHS – Oklahoma Area
				IHS – Phoenix Area
				IHS – Portland Area
				IHS – Tucson Area
				IHS – Other
				NATIONAL INSTITUTES OF HEALTH
				OFFICE OF THE SECRETARY OF HEALTH AND HUMAN SERVICES
				PROGRAM SUPPORT CENTER
				ROCKVILLE HR CENTER
PBGC
New		Would you like PBGC to contact you regarding your response?		Yes	A	Radio button, one-up vertical	S	Y	Skip Logic Group	Contact
				No
New	A	Please provide the following information, and a PBGC representative will contact you. Name: (First/Last Name)				Text field, <100 char	S	N		Name
New	A	Email: (e.g. [email protected])				Text field, <100 char	S	N		Email
New	A	Telephone: (e.g. 555-555-5555)				Text field, <100 char	S	N		Telephone
New	A	Best weekday to be reached:		Monday		Drop down, select one	S	N		Best Day to Reach
				Tuesday
				Wednesday
				Thursday
				Friday
New	A	Best time to be reached:		9 - 10 AM (EST)		Drop down, select one	S	N		Best hour to Reach
				10 - 11 AM (EST)
				11 - 12 PM (EST)
				12 - 1 PM (EST)
				1 - 2 PM (EST)
				2 - 3 PM (EST)
				3 - 4 PM (EST)
				4 - 5 PM (EST)
				5 - 6 PM (EST)
New	A	Type of assistance requested from PBGC:				Text area, no char limit	S	N		Assistance requested
BLS Full Site
		What information were you primarily looking for on this website when our survey appeared?		The Occupational Outlook Handbook		Radio button, one-up vertical	Single	Y	OPS Group	Primary Info Seeking
				Inflation or Price Information
				Pay or Benefits Information
				Employment or Unemployment Information
				Productivity Information
				Workplace Health or Safety Information
				Nothing Specific
				Something Else	A
	A	Please tell us what you were looking for				Text field, <100 char				Other_Primary Info
		How would you prefer to find information on this website?		Navigate to the information		Radio button, one-up vertical	Single	Y		How Prefer Find Info
				Use an A-Z index
				Search for the information with a search engine
		What would most improve navigation or the layout on this website?		Using a more graphical interface to find information		Radio button, one-up vertical	Single	Y	Skip Logic Group	How Improve Nav
				A brochure that describes all BLS products and how to find them
				Simplifying the homepage
				Consolidating/using fewer links
				Something else	B
	B	Please tell us what would most improve navigation or the layout of this website				Text field, <100 char		N	Skip Logic Group	OE_How Most Improve Nav
		What would most improve the search function on this website?		Filtering search results by topic, year, geography, etc.		Radio button, one-up vertical	Single	Y	Skip Logic Group	How Improve Search
				Having the search box offer search suggestions as you begin to type
				Providing suggestions on related search-terms or sources of information
				The search function worked effectively
				I did not use the search function
				I'm not sure what would improve the search function
				Something Else	C
	C	Please tell us what would most improve the search function on this website				Text field, <100 char		N	Skip Logic Group	OE_How Most Improve Search
		Was the information on this website easy to understand?		Yes		Radio button, one-up vertical	Single	Y		Info Understandable
				Somewhat
				No
AED07464		Which one of the following BEST describes you?		Accounting, Contracting, or Payroll Professional		Radio button, one-up vertical	Single	N Y	OPS Group	Best Describes
				Employer or Business Owner, or CEO/COO
				Information Technology Professional IT/IS professional, or Librarian
				Healthcare Professional
				Employment Law, Safety, Healthcare, or Insurance Specialist
				Legal Professional
				Journalist
				Marketing or Sales Professional
				Social Science Researcher
				Economist or Social Scientist
				Financial Professional/Analyst
				Student: Elementary, Middle or High School Level
				Student: College or Graduate Level
				K-12 Teacher, Professor, or School Counselor Educational Faculty, Adviser, or Administrator
				Unemployed Job-Seeker, or Changing Careers Changing Careers or Unemployed Jobseeker
				Parent Assisting Children
				Private Citizen Seeking Information (visit is not career-related)
				Human Resources Professional
				Other (please specify):	P
AED07465	P	Other best describes Please tell us what best describes your occupation				Text field, <100 char		N	OPS Group	OE_Best Describes
		How satisfied are you with the products and information provided by the Bureau of Labor Statistics?		Very satisfied		Drop down, select one	Single	Y		Sat with BLS Products and Info
				Somewhat satisfied
				Neither satisfied nor dissatisfied
				Somewhat dissatisfied
				Very dissatisfied
US MINT
MMW0986	A	What types of activities do you use your mobile device for? (Please select all that apply)	MMW0986A01	Send or receive text messages		Checkbox, one-up vertical	M	Y	Skip Logic Group	Mobile Activities Preference
			MMW0986A02	Browse websites
			MMW0986A03	Download an application (“app”)
				Read emails
				None of the above
				Sending or receiving text messages
				Reading emails
				Browsing websites
				Making phone calls
				Viewing and/or taking pictures
				Viewing and/or taking videos
				Internet browsing (searching information or reading news or articles, etc.)
				Completing web based transactions (i.e., banking, purchase merchandise, purchase services, etc.)
				Audio streaming
				Video streaming
				Playing Games
			MMW0986A04	None of the above
MMW0987	B	Of the following, what types of information from the U.S. Mint would you like to be able to access from your mobile device?	MMW0987A01	Learn about coin collecting		Checkbox, one-up vertical	M	Y	Skip Logic Group	Info Access from Mobile Device
			MMW0987A02	Research, browse, or purchase coins and medals
			MMW0987A03	Find information / news about the U.S. Mint
			MMW0987A04	None of the above
			MMW0987A05	Other, please specify:	A
MMW0988	A	What other information you would like to be able to access on your mobile device?				Text area, no char limit		N	Skip Logic Group	Other Info Access from Device
	B	Have you ever accessed the U.S. Mint site from your mobile device?		Yes	E	Checkbox, one-up vertical	S	Y	Skip Logic Group	Accessed US Mint from mobile
				No
	E	What information were you looking for when accessing the U.S. Mint site from your mobile device?				Text area, no char limit	S	N	Skip Logic Group	Info wanted on site from mobile
	C	If the U.S. Mint created a mobile site, what information would you like to see on the site?				Text area, no char limit	S	N	Skip Logic Group	Info want on mobile site
		Did you add an item to your shopping cart today?		Yes, I did	A	Radio button, one-up vertical	S	Y	Skip Logic Group	Add Item to Cart
				No, I did not	B
	A	Did you make a purchase on the U.S. Mint site ?		Yes, I did		Radio button, one-up vertical	S	Y	Skip Logic Group	Make a Purchase
				No, I did not	C
	B	Why did you not add an item to your shopping cart today?		I did not come to the site with the intent to purchase		Radio button, one-up vertical	S	Y	Skip Logic Group	Make a Purchase
				The item I wanted to purchase is not available/not released yet
				I need more information before purchasing
				I did not understand how to add a product to my shopping cart
				I had a technical error when trying to add an item to my shopping cart
				Other, please specify	D
	D	Please describe why you did you not add an item to your shopping cart today?				Text area, no char limit	S	N	Skip Logic Group	Did not Add Item to Cart
	C	What was the primary reason for not purchasing the item(s) in your cart?		Just browsing / not sure if I really want the item	T	Radio button, one-up vertical	S	Y	Skip Logic Group	Did not Purchase Reason
				Need more information before purchasing	BB
				Product is not available/not released yet
				Price is too expensive
				Shipping cost is too expensive
				Trouble entering my shipping/billing address	CC
				Technical error while trying to purchase	E
				Other, please specify:	G
	G	Other reason for not purchasing:				Text area, no char limit	S	N	Skip Logic Group	Other Reason Not Purchase
	T	What additional information could we provide to help you make a decision?				Text area, no char limit	S	N	Skip Logic Group	Add Info Help Decision
	BB	What additional information would you like to have before making a purchase?				Text area, no char limit	S	N	Skip Logic Group	Add Info Before Purchase
	CC	What kind of trouble did you have?				Text area, no char limit	S	N	Skip Logic Group	Trouble
	E	What kind of technical error or issue did you experience?				Text area, no char limit	S	N	Skip Logic Group	Technical Error
		When do you plan on making a purchase from the U.S. Mint website?		Today		Radio button, one-up vertical	Single	Y		Purchase Timing
				In the next week
				In the next month
				In the next 1-3 months
				As soon as the product I am looking for is released
				Never
			MMW0984A03	Not Sure
TRICARE
MMM00061		Which of the following best describes your main reason for visiting our Web site today?		Find out what’s covered		Radio button, one-up vertical	Single	Y	Randomize
				Look up costs
				Find a civilian/network provider
				Find a military provider
				Find a military or civilian doctor
				Make an appointment
				Referral
				Look up a toll free phone number
				Find contact information
				File a claim
				Check the status of a claim
				Problem with a claim
				Find claims information
				Enroll
				Pay Enrollment Fees
				Find enrollment information
				Pharmacy
				Check eligibility
				Update personal information
				Learn about the plans / options
				Look up health information / medical advice
				Look for health/wellness information
				Other (please explain)	A
NEW	2A	Please describe your experience with the site's search feature.		Very helpful		Radio button, one-up vertical	Single	No
				Somewhat helpful	3A, 3B
				Not at all helpful	3A, 3B
ACQOsl0002176	H	Please describe your experience with the site's search feature?	ACQOsl0002176A01	I had no difficulty using the search feature on this site		Radio button, one-up vertical	Single	No	SKIP LOGIC GROUP
			ACQOsl0002176A02	The search feature was difficult to find
			ACQOsl0002176A03	The search feature was difficult to use
			ACQOsl0002176A04	Returned no results/received an error message
			ACQOsl0002176A05	Could not tell where the search results would take me
			ACQOsl0002176A06	Too many results
			ACQOsl0002176A07	Too few results
			ACQOsl0002176A08	Results were not related to what I was looking for
			ACQOsl0002176A09	Could not sort the results
			ACQOsl0002176A10	Could not refine the results
			ACQOsl0002176A11	Other	1B
ACQwil0013629	1B	What other experience did you have with the site's search feature?				Text area, no char limit
ACQOsl0002177	H, 3A, 3B	What key word(s) did you use to search?				Text area, no char limit		No	SKIP LOGIC GROUP
NEW	3A, 3B	What information were you searching for on the site?				Text area, no char limit
ACQOsl0002178	H	Please indicate how helpful you feel the search feature was in finding the information you wanted/needed?	ACQOsl0002178A01	Very helpful		Radio button, one-up vertical	Single	No	SKIP LOGIC GROUP
			ACQOsl0002178A02	Somewhat helpful	I
			ACQOsl0002178A03	Not at all helpful	I, J
ACQOsl0002179	J	Why do you feel the search feature was not at all helpful?				Text area, no char limit		No	SKIP LOGIC GROUP
ACQOsl0002180	I	What would make the search feature more helpful?				Text area, no char limit		No	SKIP LOGIC GROUP
NOAA
New		Which of the following professional groups should NGS engage with, in addition to the surveying community?		Emergency responders		Radio button, one-up vertical	Single	Y	Skip Logic	Professional Groups
				Energy producers
				Agriculture
				Coastal management
				Other, please specify	A
New	A	Please specify any other professional groups NGS should engage with.				Text area, No Limit	Single	N		OE_Professional Groups
New		Which geodesy / remote sensing topics should NGS explain better, or provide tutorials on?		Shoreline; the role of geodesy and remote sensing in ensuring safe navigation		Radio button, one-up vertical	Single	Y	Skip Logic	Geodesy or Sensing Topics
				Crustal and land movement; the role of geodesy and remote sensing in updating positions where significant crustal and land movement occurs
				Geographic Information Systems (GIS); the role of geodetic control in GIS
				Other, please specify	A
New	A	Please specify the topics NGS should explain better.				Text area, No Limit	Single	N		OE_Geodesy or Sensing Topics
New		Regarding accurate positioning, what is the most important issue or challenge in your profession?		Obtaining geodetic control in the field		Radio button, one-up vertical	Single	Y	Skip Logic	Accurate pos issue
				Identifying land subsidence or uplift sea-level changes
				identifying shoreline ore sea-level changes
				Defining the relationship between land elevations and water levels
				Other, please specify	A
New	A	Please specify the most important accurate positioning issue or challenge in your profession.				Text area, No Limit	Single	N		OE_Accurate Pos Issue
New		What is the primary reason passive survey control marks (e.g., bench marks) are important to your work?		Using these marks is required by federal, state, or local requirements		Radio button, one-up vertical	Single	Y	Skip Logic	Survey Controls Impt
				Using these marks is included in contract terms
				I can't depend on satellite systems being available in the areas where I work
				Other, please specify	A
New	A	Please specify why passive survey control marks are important to your work.				Text area, No Limit	Single	N		OE_Survey Controls impt
New		Which of the following primarily drives your accuracy needs?		Legal requirements		Radio button, one-up vertical	Single	Y	Skip Logic	Drives Accuracy Needs
				Scale of what I am measuring requires high accuracy
				I want the highest accuracy possible
				I don’t have high accuracy requirements; within a few feet is good enough.
				not applicable – I am visiting this site for other reasons
				Other, please specify	A
New	A	Please specify what primarily drives your accuracy needs.				Text area, No Limit	Single	N		OE_Drives Accuracy Needs
New		Which of the following best describes the datum realization you are most likely to use?		I use whatever datum realization my original dataset is in.		Radio button, one-up vertical	Single	Y	Skip Logic	Datum Realization
				I use the most recent datum realization.
				I use the datum realization I am most comfortable with.
				I do not make a distinction between datum realizations.
				not applicable – I am visiting this site for other reasons
				Other, please specify	A
New	A	Please specify the datum realization you are most likely to use.				Text area, No Limit	Single	N		OE_Datum Realization
NAIAD
SAC4023		Please rank the top 3 factors that brought you to the website today. (Rank 1 = Most important) Rank 1	SAC4023A001	Message or recommendation from a friend on a social network		Drop down, select one	Single	Y	Rank Group	SV - Rank 1
			SAC4023A002	Video I saw on YouTube
			SAC4023A003	Internet blogs or discussion forums					Adjust Template/Style Sheet
			SAC4023A004	Advertising on social networks (Facebook, My Space, Twitter)					Randomize
			SAC4023A005	Message directly from NIAID on a social network
			SAC4023A006	Mobile phone text messages or alerts
			SAC4023A007	Instant Message from a friend or colleague
			SAC4023A008	Familiarity with site/organization
			SAC4023A009	Email Alerts
			SAC4023A010	Search engine results
			SAC4023A011	Word of mouth recommendation from someone I know
			SAC4023A012	TV, radio, newspaper, or magazine advertising
			SAC4023A013	Internet advertising
			SAC4023A014	Link from another website
			SAC4023A015	Don't know					Anchor Answer Choice
			SAC4023A016	Other					Anchor Answer Choice
SAC4024		Rank 2	SAC4024A001	Message or recommendation from a friend on a social network		Drop down, select one	Single	N	Rank Group	SV - Rank 2
			SAC4024A002	Video I saw on YouTube
			SAC4024A003	Internet blogs or discussion forums					Adjust Template/Style Sheet
			SAC4024A004	Advertising on social networks (Facebook, My Space, Twitter)					Randomize
			SAC4024A005	Message directly from NIAID on a social network
			SAC4024A006	Mobile phone text messages or alerts
			SAC4024A007	Instant Message from a friend or colleague
			SAC4024A008	Familiarity with site/organization
			SAC4024A009	Email Alerts
			SAC4024A010	Search engine results
			SAC4024A011	Word of mouth recommendation from someone I know
			SAC4024A012	TV, radio, newspaper, or magazine advertising
			SAC4024A013	Internet advertising
			SAC4024A014	Link from another website
			SAC4024A015	Don't know					Anchor Answer Choice
			SAC4024A016	Other					Anchor Answer Choice
SAC4025		Rank 3	SAC4025A001	Message or recommendation from a friend on a social network		Drop down, select one	Single	N	Rank Group	SV - Rank 3
			SAC4025A002	Video I saw on YouTube
			SAC4025A003	Internet blogs or discussion forums					Adjust Template/Style Sheet
			SAC4025A004	Advertising on social networks (Facebook, My Space, Twitter)					Randomize
			SAC4025A005	Message directly from NIAID on a social network
			SAC4025A006	Mobile phone text messages or alerts
			SAC4025A007	Instant Message from a friend or colleague
			SAC4025A008	Familiarity with site/organization
			SAC4025A009	Email Alerts
			SAC4025A010	Search engine results
			SAC4025A011	Word of mouth recommendation from someone I know
			SAC4025A012	TV, radio, newspaper, or magazine advertising
			SAC4025A013	Internet advertising
			SAC4025A014	Link from another website
			SAC4025A015	Don't know					Anchor Answer Choice
			SAC4025A016	Other					Anchor Answer Choice
regulations.gov
ALM0164		Were you able to accomplish what you wanted to do on Regulations.gov today?		Yes		Radio Button One Up Vertical	Single	Y	Skip Logic Group
				No	A, B
	A	Why weren't you able to accomplish your task today?				Text field, <100 char		N		Not able to accomplish
AKR1359	A	Since you did not accomplish what you wanted, what do you intend to do next?		Try this site again later		Radio Button One Up Vertical	Single	Y
				Call the helpdesk
				Submit webform to helpdesk
				Contact department/agency directly
				Nothing-I give up
				Try another site (please specify)	B
AKR1360	B	If you will try another site, please specify:				Text field, <100 char		N
	B	Did you, or do you plan to, contact any of the following for help with what you could not accomplish today?		Yes, the helpdesk		Checkbox, one-up vertical	Multi	N
				Yes, a specific department/agency directly
				No, I do not plan to contact any of the above resources
				No, I give up on trying to accomplish my task
CWS01245	B	Please tell us about your other experience. --> Please tell us about your other experience while navigating Regulations.gov today.				Text field, no char limit		N	Skip Logic
FDA
Please rate how well the search result descriptions helped you decide which one to select.	Model Question
Please rate how well the search results provided the information needed to narrow or refocus your search.	Model Question
Palmetto J1 MAC
NEW		Have you connected with Palmetto GBA on a social network? Please check all that apply.		No, I have not	SKIP G	Checkbox, one-up vertical	Multi	Yes	Skip Group	Connected
				Facebook
				LinkedIn
				YouTube
				Twitter
				Mobile apps
				Other, please specify	SHIP H
NEW	SKIP H	Please specify the social network.				Text area, no char limit		No	Skip Group	Specify Network
NEW	SKIP G	Would you like to be directed to our Stay Connected Page after completing this survey?		Yes		Radio button, one-up vertical		No	Skip Group	Direct To SCP
				No
Palmetto GBA Railroad
NEW		Have you connected with Palmetto GBA on a social network? Please check all that apply.		No, I have not	SKIP G	Checkbox, one-up vertical	Multi	Yes	Skip Group	Connected
				Facebook
				LinkedIn
				YouTube
				Twitter
				Mobile apps
				Other, please specify	SKIP H
NEW	SKIP H	Please specify the social network.				Text area, no char limit		No	Skip Group	Specify Network
NEW	SKIP G	Would you like to be directed to our Stay Connected Page after completing this survey?		Yes		Radio button, one-up vertical		No	Skip Group	Direct To SCP
				No
Palmetto GBA J11
NEW		Have you connected with Palmetto GBA on a social network? Please check all that apply.		No, I have not	SKIP K	Checkbox, one-up vertical	Multi	Yes	Skip Group	Connected
				Facebook
				LinkedIn
				YouTube
				Twitter
				Mobile apps
				Other, please specify	SKIP L
NEW	SKIP L	Please specify the social network.				Text area, no char limit		No	Skip Group	Specify Network
NEW	SKIP K	Would you like to be directed to our Stay Connected Page after completing this survey?		Yes		Radio button, one-up vertical		No	Skip Group	Direct To SCP
				No
IRS Sat Survey v2
CWS05373		Which category best describes you? Are you …?		An individual taxpayer	B	Radio button, one-up vertical	Single	Y	Skip logic	Role
				Representing a business	D
				Representing a charity or non-profit organization
				Representing a government entity
				A tax professional (i.e. accountant, attorney, bank trust officer, enrolled agent, tax consultant, tax preparer, etc.)
				An academic/researcher
				A Student
				Military
				Retirement fund administrator
				An IRS employee
				A VITA/TCE volunteer
				Other	A
CWS05374	A	Please specify other role.				Text field, <100 char		N		Other role
	B	Please specify your individual taxpayer role.		Employee		Radio button, one-up vertical	Single	Y		Individual
				Self employed
				International taxpayer
				Parent
				Student
				Senior and/or retiree
				Other, please specify:	C
	C	Other individual role:				Text field, <100 char		N		Other individual
	D	Please specify your business type.		Corporation		Radio button, one-up vertical	Single	Y		Business
				Partnership
				International business
				Small business & self employed
				Other, please specify:	E
	E	Other business type:				Text field, <100 char		N		Other business
		What area/section of the site are you primarily visiting today?		Filing		Radio button, one-up vertical	Single	Y		Area Visited
				Payments
				Refunds
				Credits & Deductions
				News & Events
				Forms & Publications
				Help & Resources
				For Tax Professionals
				Hot Topics
				Tools
				Social Media
				Other
CWS05375		What is your primary reason for coming to the IRS.gov website today?		Download a current tax form, publication, or instructions		Radio button, one-up vertical	Single	Y	Skip logic	Reason
				Filing a return
				Payment plan
				Refund status
				General tax information	A
				Amended tax return status
				Prior year tax form, publication, or instructions
				Ordering forms from the IRS
				Tax return or account transcript
				Mailing addresses for tax forms
				e-file information
				e-file PIN
				Free File information	C,D
				Prepare my taxes via Free File on the IRS website	D
				Tax calculators/worksheets
				e-Services
				PTIN	B
				EIN
				Tax regulations or written determinations
				Revenue rulings or court cases
				Tax statistics
				Link and Learn (VITA/TCE) training
				Contact information
				Subscription sign-up
				Non-English language information
				Latest news releases
				IRS social media tools
				Other, please specify:	A
CWS05376	A	If you answered "Other" or "Obtain general tax information" as a primary reason, please specify.				Text area, no char limit		N		Other reason/general info
CWS05379		Including today, how many times did you contact the IRS about your Primary Reason for using IRS.gov?		Once (today was the first time)		Drop down, select one	Single	Y		# contacted IRS
				Twice
				Three times
				Four or more Times
CWS05383		How did you find information on our website today? (Please mark all that apply.)		IRS.gov search	B,C,E	Checkbox, one-up vertical	Multi	Y	Skip logic	Method
				Advanced search	B,C,E
				Forms and publications area	B,C,E
				Site navigation	B,C,E
				Navigation to the web page	B,C,E
				Links on a page	B,C,E
				Site Map	B,C,E
				Bookmarks
				Internet search engine (e.g., Google, MSN Search, Yahoo! Search, etc.)
				Links to IRS.gov from other websites
				Other, please specify:	A
CWS05384	A	Please specify other method.				Text field, <100 char		N		Other method
CWS05385	B	What specific search term(s) did you use to find information on the IRS website?				Text area, no char limit		N		Search terms
CWS05386	C	If you performed a search on IRS.gov today, what type of difficulty, if any, did you encounter? (Please choose one response only.)		Delivered the expected results		Radio button, one-up vertical	Single	N		Search diff
				Top recommendations were helpful
				Auto-complete feature was helpful
				Too many results returned
				No results returned
				Results irrelevant to search terms
				Results were too similar/redundant
				Unsure of search terms to use
				Search required too many refinements to get what I wanted
				Search speed was too slow
				Other, please specify:	D
CWS05387	D	If you answered "Other" above, please specify other search difficulty.				Text area, no char limit		N		Other search diff
CWS05388	E	What type of difficulty, if any, did you encounter with the navigation on the IRS website? (Please choose one response only.)		Navigation worked as expected		Radio button, one-up vertical	Single	N		Navigation diff
				Navigation terms were intuitive
				Banners and promotions were appropriate/useful
				Consistent page elements (header and footer) made navigation easier
				First-level navigation was intuitive, but subsequent levels were less intuitive
				Expected links were not present on Web pages
				Links did not take me where I expected
				Navigating through site and determining location on site was difficult
				Navigation was not helpful
				Could not find the appropriate navigational links on most of your web pages
				Could not get started or did not know where to begin
				Too many links or navigational choices
				Would often feel lost, and did not know where I was on your website
				Navigation did not support what I was trying to accomplish
				Could not navigate back to previous information
				Had difficulty finding detailed information on your web pages
				Encountered technical difficulties (links didn't work, received error messages, etc.)
				Other, please specify:	F
FDA
		In addition to visiting the FDA site, what other sites might you visit to find the information you are looking for?				Text area, no char limit	Single	N		Additional Sites
PBGC
SAC4233		Which best describes you?		United Airlines worker or retiree		Radio button, one-up vertical	Single	Y	Skip logic group	Role
			SAC4233A001	Worker or retiree
			SAC4233A002	Widow(er) or spouse or beneficiary
			SAC4233A003	Researcher or student
			SAC4233A004	Practitioner or pension professional
			SAC4233A005	Media or press representative
			SAC4233A006	Trade association or business organization
			SAC4233A007	Other (please specify)	A
SAC4234	A	Other - best describes you:				Text field, <100 char		N	Skip logic group	OE_Role
SAC4244		Did you search by name, company, or state in PBGC’s missing participant list Unclaimed Pension Search?	SAC4244A001	Yes	A	Radio button, one-up vertical	Single	Y	Skip logic group	Missing participant list
			SAC4244A002	No
SAC4245	A	On a scale of 1 to 10, please rate the ease of using PBGC’s missing participant list Unclaimed Pension Search.	SAC4245A001	1 = Very Difficult	B	Radion button, scale, no don't know	Single	Y	Skip logic group	Ease of using MPL
			SAC4245A002	2	B
			SAC4245A003	3	B
			SAC4245A004	4	B
			SAC4245A005	5	B
			SAC4245A006	6	B
			SAC4245A007	7	B
			SAC4245A008	8	B
			SAC4245A009	9	B
			SAC4245A010	10 = Very Easy	B
SAC4246	B	Please tell us about your experience with PBGC’s missing participant list Unclaimed Pension Search. (Select all that apply)	SAC4246A001	I wasn’t sure what the list was		Checkbox, one-up vertical	Multi	Y	Skip logic group	Problems with MPL
			SAC4246A002	I found myself or my pension plan
			SAC4246A003	I didn’t find myself or my pension plan
			SAC4246A004	Search results were helpful
			SAC4246A005	Search results were not helpful
			SAC4246A006	Returned too many results
			SAC4246A007	Returned not enough or zero results
			SAC4246A008	Other (please specify)	C
SAC4247	C	Please specify your experience with PBGC’s missing participant list Unclaimed Pension Search.				Text area, no char limit		N	Skip logic group	OE_MPL experience
SAC4235		Why did you visit PBGC's website today?	SAC4235A001	To find information about my pension plan		Radio button, one-up vertical	Single	Y	Skip logic group	Purpose
			SAC4235A002	To search for unclaimed pensions on PBGC’s missing participant list Unclaimed Pension Search
			SAC4235A003	To log in to MyPBA (worker or retiree info)
			SAC4235A004	To obtain tax information or Form 1099					Randomize
			SAC4235A005	To follow up on an annual funding notice I received
			SAC4235A006	To find premium-related information
			SAC4235A007	To log in to My PAA (premium-related matters)
			SAC4235A008	To research plan termination
			SAC4235A009	To find information and news about PBGC
			SAC4235A010	To find information on defined benefit pensions
			SAC4235A011	Other (please specify)	A	Pin Answer Choice
SAC4236	A	Other - purpose in visiting PBGC's website today:				Text area, no char limit		N	Skip logic group	OE_Purpose
PSC Offiline v2
Representative - Professionalism		Thinking about the representative you who worked with you, please rate the following: Please rate the professionalism of the representative.
FDIC App v3
ACQwil0012243		Which of the following web applications did you use today? (Select all that apply)	ACQwil0012243A01	Bank Find		Checkbox, one-up vertical	Multi	y		App Use
			ACQwil0012243A02	Institution Directory
			ACQwil0012243A03	Summary of Deposits
			ACQwil0012243A04	Statistics on Depository Institutions
			ACQwil0012243A05	Statistics on Banking
			ACQwil0012243A06	Historical Statistics on Banking
				Real Estate for Sale
			ACQwil0012243A07	Other