0923-0047 AttB ATSDR Customer Satisfaction Survey Questionnaire

Attachment B. Invitation for ATSDR Customer Survey Questionnaire

Form Approved

OMB No. 0923-0047

Exp. Date 05/31/2016

Public reporting burden of this collection of information is estimated to average 5 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 CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS- D-74, Atlanta, Georgia 30333; ATTN:PRA (0923-0047).

In order to better serve you The Agency for Toxic Substances and Disease Registry (ATSDR) would like you to participate in a short survey to help us better understand how well ATSDR did in answering your questions about this site. Your responses will be completely confidential. Please mark your responses for each question directly on the questionnaire.

1. How would you like to receive updates about the site?

• Regular mail

• Email

2. Presentation materials about the site (handouts, videos, visual aids, on-screen presentations) were accurate and useful?

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

3. Was presentation material about the site too detailed?

• Much too detailed

• Just right

• Not detailed enough

4. The ATSDR representative showed enthusiasm for the subject matter and emphasized its importance.

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

5. The ATSDR representative thoroughly explained the subject matter pertaining to the site.

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

6. Do you understand ATSDR’s key findings about the site?

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

7. Do you understand what you need to do to protect your health?

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

8. Do you understand ATSDR’s next steps about the site?

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

9. The level of detail of ATSDR’s next steps is?

• Much too detailed

• Just right

• Not detailed enough

10. I am satisfied with the expertise of the ATSDR representatives.

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

11. I am satisfied with the work ATSDR has done in my community pertaining to this site.

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

12. ATSDR representatives answered my question(s) to my level of satisfaction.

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

13. ATSDR representatives addressed my concerns..

• Agree

• Somewhat Agree

• Somewhat Disagree

• Disagree

Page | 4