Form 35 Attach 3 - CTSU Helpdesk Customer Satisfaction Survey

Attachment 3 page 5 of 5

OMB #: 0925-xxxx

Expiry Date: xx/xx/xxxx

CTSU Customer Service Satisfaction Survey

Questions

Public reporting burden for this collection of information is estimated to vary from 10 to 15 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-xxxx). Do not return the completed form to this address

1) Which Help Desk do you contact most frequently?

_____ CTSU Main Help Desk

_____ CTSU Regulatory Help Desk

_____ Both CTSU Main Help Desk and CTSU Regulatory Help Desk equally

Please rate your level of satisfaction with the following aspects of the CTSU Main Help Desk. These questions apply to your most recent help desk experience.

2) Generally, how frequently do you or your staff utilize the Main Help Desk Services?

_____ Frequently (weekly)

_____ Moderately (monthly)

_____ Occasionally

_____ Once

3) How would you rate your satisfaction with the ability of the Main Help Desk Staff to provide an acceptable solution to your inquiry?

_____ Extremely satisfied

_____ Satisfied

_____ Neutral

_____ Dissatisfied

_____ Extremely dissatisfied

4) If you contacted the Help Desk by e-mail or had to leave a voice mail, how would you rate your satisfaction with the length of time required by the Main Help Desk to provide a response to your inquiry?

_____ Extremely satisfied

_____ Satisfied

_____ Neutral

_____ Dissatisfied

_____ Extremely dissatisfied

5) How would you rate your satisfaction with the level of knowledge demonstrated by the Main Help Desk Staff regarding the subject(s) of your inquiry?

_____ Extremely satisfied

_____ Satisfied

_____ Neutral

_____ Dissatisfied

_____ Extremely dissatisfied

6. In reference to Question #5, please indicate the subject(s) of your inquiry:

7) If your inquiry had to be referred to other CTSU or Cooperative Group Staff, how satisfied were you with the length of time needed to obtain a final response from the Main Help Desk?

_____ Extremely satisfied

_____ Satisfied

_____ Neutral

_____ Dissatisfied

_____ Extremely dissatisfied

8) Regarding your most recent contact with the CTSU Main Help Desk, what is your overall level of satisfaction with the services provided?

_____ Extremely satisfied

_____ Satisfied

_____ Neutral

_____ Dissatisfied

_____ Extremely dissatisfied

9) Please provide us with comments and/or suggestions about our Main Help Desk Services.

Please rate your level of satisfaction with the following aspects of the CTSU Regulatory Help Desk.

10) Generally, how frequently do you or your staff utilize the Regulatory Help Desk Services?

_____ Frequently (weekly)

_____ Moderately (monthly)

_____ Occasionally

_____ Once

11) As a result of your contact(s) with the Regulatory Help Desk Staff, please indicate in which areas you gained a better understanding of the submission processes and/or regulatory requirements. Mark all that apply.

_____ Initial Approval submissions

     _____ Continuing Renewal submissions

     _____ Amendment Approval submissions

     _____ Special Requirements set up for collection by the Lead Group of a trial

     _____ Renewal Submission after a Protocol is Closed to Accrual

     _____ Documentation required when using the NCI CIRB

     _____ FWA Updates submissions

12) As a result of your contact(s) with the Regulatory Help Desk Staff, please indicate if you gained a better understanding of any of the following areas. Mark all that apply.

     _____ Investigator's NCI Status

     _____ Requests for Protocol Related Material

     _____ Identifying Contacts for Protocol Related Questions

     _____ Roster Information for Your Site

     _____ Navigation of CTSU Web Site

13) How would you rate your satisfaction with the overall level of assistance provided by the Regulatory Help Desk regarding your topic(s) of inquiry?

_____ Extremely Satisfied

_____ Satisfied

_____ Neutral

_____ Dissatisfied

_____ Extremely Dissatisfied

14) Please provide us with comments and/or suggestions about our Regulatory Help Desk Services.

Please complete the following questions if you have enrolled patients through the CTSU:

Patient Registrar Questions

Please rate your level of satisfaction with the following aspects of the CTSU Patient Registration Services. These questions apply to your most recent Patient Registration experience.

15) Generally, how frequently do you utilize the CTSU Patient Registrar Services?

_____Frequently (weekly)

_____Moderately (monthly)

_____Occasionally

_____Rarely

16) How would you rate your satisfaction with the length of time required by the CTSU Patient Registrars to process your enrollment and provide you with a confirmation of the registration?

_____Extremely satisfied

_____Satisfied

_____Neutral

_____Dissatisfied

_____Extremely dissatisfied

17) How would you rate your overall satisfaction with the services provided by the Patient Registrars?

__________Extremely satisfied

__________Satisfied

__________Neutral

__________Dissatisfied

__________Extremely dissatisfied

18) Please provide us with comments and/or suggestions about the Patient Registrar Services.

19) Would you like to enter a drawing for a chance to win a $25 Visa gift card?

-Yes

-No