Form 1 Telehealth Website - Page Level - SurveyEngSpan

OMB No. 0915-0212

Expires: 7/31/2021

Telehealth.HHS.gov Page-Level Website Survey

Note: Survey will be available in English and Spanish.

Page-Level Website Survey

English

Was this page useful?

• Yes

• No

(If no) This page was not useful because (select all that apply):

• The information is confusing or unclear

• I didn’t find what I was looking for

• Other reason: [Free text field]

(If yes or no) How can we improve this page? (optional)

• [Free text field]

Spanish

¿Fue útil esta pagina?

• Sí

• No

(Si no) Esta página no fue útil porque (seleccione todas las respuestas que correspondan):

• La información es confusa o poco clara

• No encontré lo que buscaba

• Otro motivo:

(Si es sí o no) ¿Cómo podemos mejorar esta página? (opcional)

Public Burden Statement: HRSA’s Federal Office of Rural Health Policy (FORHP) will obtain feedback from users of Telehealth.HHS.gov that was recently funded through the CARES Act (P.L. 116-136, P.L. 88-426, 5 U.S.C. 101, 42 U.S.C. Section 210), as amended. 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 information collection is 0915-0212 and it is valid until 7/31/2021. This information collection is voluntary. Public reporting burden for this collection of information is estimated to average .007 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 14N136B, Rockville, Maryland, 20857 or [email protected].