D3 - Instructions for Accessing Survey

D3. Instructions for Accessing the Web Survey

Form Approved

OMB No. 0920-xxxx

Exp. Date: XX/XX/XXXX

National Survey of Community-Based Policy and
Environmental Supports for Healthy Eating and Active Living

INSTRUCTIONS FOR ACCESSING THE WEB-BASED SURVEY SYSTEM

INSTRUCTIONS: Thank you for your participation in the Centers for Disease Control and Prevention (CDC) National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS HEAL National Survey). You may need to consult with a representative from another department to provide the most accurate and complete information on your local government’s policies. Examples of people with whom you might need to consult include a parks and recreation department representative, a procurement or purchasing office representative, or a transportation department representative.

• To access the survey, go to https://www.WEBSITEHERE.com.

• Next enter your unique access ID, or token: XXXXXXXXX. Your token can be used an infinite amount of times until the survey is submitted as final.

• Use your mouse to click on the best response option based on what you know about the policies and initiatives in place in your community. Do not use the browser’s back button to navigate through the questionnaire. Please use the arrows at the bottom of each page.

• Your answers will automatically be saved as you advance through the questionnaire.

• You may notice that the numbering of the questions may not progress sequentially as you advance through the questionnaire. This is due to skip patterns resulting from previous answer choices. This is intentional and requires no action or resolution on your part.

• If you need input from others to complete the survey, you can share the token with them. Please note, however, that two people cannot access the system with the same token at the same time.

• Your responses will be stored, but the survey will not be completed until you select the SUBMIT AS FINAL button. Once this option is selected, your responses are final and cannot be changed.

• Your token is valid until the survey is submitted.

• Once the survey is completed, you have the option of printing it for your records. You can print by selecting the X command.

• Submit your survey by selecting the SUBMIT AS FINAL button.

Option: Completing a paper copy of the survey. If you prefer, you can complete the survey in hard-copy form by saving the survey as X file and printing it on your local computer. By hand, write the token as your ID number on the first page of the hard-copy form. The completed, hard-copy survey should be mailed care of Walter Rives, CBS Survey, ICF International, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705.

Public reporting burden of this collection of information is estimated to average 30 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 Reports Clearance Officer, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-XXXX).