3 DATA CoIIN_Web-based Shared workspace/Online Platform Su

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. The
OMB control number for this project is 0915-xxxx. Public reporting burden for this
collection of information is estimated to average xx hours per response, including the
time for reviewing instructions, searching existing data sources, and completing and
reviewing the collection of information. Send comments regarding this burden estimate
or any other aspect of this collection of information, including suggestions for reducing
this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N-39,
Rockville, Maryland, 20857.

OMB Number (0915-XXXX) Expiration Date (XX/XX/201X)

IM CoIIN Platform Survey
1) Overall, how well does our website meet your needs?*
( ) Very Dissatisfied

( ) Dissatisfied

( ) Neutral

( ) Satisfied

( ) Very Satisfied

2) How easy was it to find what you were looking for? (0=Easy, 10=Difficult)*
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( ) 10

3) Did it take you more or less time than you expected to find what you were looking for on
our website? (0=Less Time, 10=More Time)*
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( ) 10

4) How visually appealing is our website? (0=Appealing, 10=Unappealing)*
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( ) 10

5) How easy is it to understand the information on our site? (0=Easy, 10=Difficult)*
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( ) 10

6) How much do you trust the information on our website? (0=Trust, 10=Distrust) *
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( ) 10

OMB Number (0915-XXXX) Expiration Date (XX/XX/201X)

7) How easy was it to post documents/resources on the website? (0=Easy, 10=Difficult) If
you did not use this function of the website, please skip this question.
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( ) 10

8) How easy was it to download documents/resources from the website? (0=Easy,
10=Difficult) If you did not use this function of the website, please skip this question.
()0

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( ) 10

9) How easy was it to use the calendar? (0=Easy, 10=Difficult) If you did not use this
function of the website, please skip this question.
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( ) 10

10) How easy was it to submit data? (0=Easy, 10=Difficult) If you did not use this function
of the website, please skip this question.
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( ) 10

11) What functions of the website are most helpful?*
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12) What functions of the website are least helpful?*
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OMB Number (0915-XXXX) Expiration Date (XX/XX/201X)

____________________________________________

13) What functions of the website need improvement? *
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Thank you for your time and participation!

OMB Number (0915-XXXX) Expiration Date (XX/XX/201X)