Form 981 2016 981 NIAMS Feedback Questionnaire_6 16 2016
E-Government Website Customer Satisfaction Surveys
2016 981 NIAMS Feedback Questionnaire_6 16 2016.xlsx
2016 981 NIAMS Feedback Questionnaire_6 16 2016
OMB: 1090-0008
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1090-0008 can be found here:
Document [xlsx]
Download: xlsx | pdf
Current CQs
Overview
Welcome and Thank You TextCurrent CQs
Sheet 1: Welcome and Thank You Text
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| Welcome and Thank You Text | ||||||
| Welcome Text | Thank You Text | |||||
| We Welcome Your Feedback Your answers will help us make improvements to the site. |
Thank you for your time. We appreciate your feedback. |
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| Welcome Text - Alternate | Thank You Text - Alternate | |||||
Sheet 2: Current CQs
| NIAMS Feedback | (Model Name) |
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| Model ID | (MID) | Underlined & Italicized: Re-order | |||||||
| Partitioned | No | Pink: Addition | |||||||
| Date | 6/1/2016 | Blue: Reword | |||||||
| QID | QUESTION META TAG | Skip From | Question Text | Answer Choices | Skip To | Required Y/N |
Type | Special Instructions | CQ Label |
| What is your overall satisfaction with this site? | 1=Very Dissatisfied | Y | Drop down, select one | Overall Sat | |||||
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| 10=Very Satisfied | |||||||||
| How well does this site meet your expectations? | 1=Falls Short | Y | Drop down, select one | Meet Expectations | |||||
| 2 | |||||||||
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| 10=Exceeds | |||||||||
| How does this site compare to your idea of an ideal website? | 1=Not Very Close | Y | Drop down, select one | Ideal Website | |||||
| 2 | |||||||||
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| 10=Very Close | |||||||||
| Please share your feedback about this page. Select the category that best describes your feedback. | Content | A | N | Text area, no char limit | Page Feedback | ||||
| Look & Feel | B | ||||||||
| Navigation | C | ||||||||
| Search Tool | D | ||||||||
| Other | E | ||||||||
| A | What would you like to tell us regarding content? | N | Text area, no char limit | Content Feedback | |||||
| B | What would you like to tell us regarding look and feel? | N | Text area, no char limit | Look & Feel Feedback | |||||
| C | What would you like to tell us regarding navigation? | N | Text area, no char limit | Nav Feedback | |||||
| D | What would you like to tell us regarding the search tool? | N | Text area, no char limit | Search Feedback | |||||
| E | What would you like to tell us? | N | Text area, no char limit | Other Feedback | |||||
| Which of the following best describes your role in coming to the website? | Family member of a patient | Y | Drop down, select one | Role | |||||
| General public | |||||||||
| Government staff/ policy professional | |||||||||
| Health professional/primary care | |||||||||
| Insurance services/ health system infrastructure staff | |||||||||
| Non-Profit/ Professional organization staff | |||||||||
| Patient | |||||||||
| Scientist/Researcher | |||||||||
| Student | |||||||||
| Teacher | |||||||||
| Other | |||||||||
| Were you able to accomplish your task? | Yes | Y | Drop down, select one | Task Accomplishment | |||||
| No | |||||||||
| Somewhat | |||||||||
| Please share any general comments or feedback for improvements to the overall website. | Text area, no char limit | General Site Feedback | |||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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