Consent

E-Consent Forms -CDC-Template-Nav-2018 OMB.DOCX

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Consent

OMB: 0920-1050

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Attachment E

CDC Template navigation: Consent Forms



We are interested in your opinion!

We would like your feedback on the Centers for Disease Control and Prevention’s (CDC) website.

We want to know what works well for you and what doesn't, so that we can further improve the design of this website. 

 During this session, we'll

  1. Ask you to give us feedback on the website

  2. Ask you to perform a series of tasks to find information on the website

After you finish all of the tasks, we'll also ask you for your thoughts on the design and suggestions for improvement. The whole exercise will take approximately 60 minutes to complete. 

To consent to the use and release of this information, please sign below.

Thank you for your time.  Your opinion is very valuable to us! 



Name: _________________________________________________



Signature: _______________________________________________



Date: ___________________________________________________









File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorCDC User
File Modified0000-00-00
File Created2021-01-21

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