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Attachment B
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![3D"Centers](3D"NCHS2011ConSURVEYAtt.B_files/image001.jpg")
Centers for Disease Control and Prevention, National Center for
Health Statistics User Survey
You've been selected=
to
participate in a short, 13-question customer satisfaction survey. This surv=
ey
will NOT capture any personally-identifiable information. All submissions a=
re
voluntary and anonymous. Your participation is extremely important, and wil=
l be
used to improve NCHS' products and services. All information will be treated
confidentially. Thank you for helping NCHS.
This survey has been approved by the Executi=
ve
Office of the President Office of Management and Budget (OMB). (Form Approv=
ed
OMB No. 0920-0729 Exp. Date 04/30/2014).
NOTICE - Public reporting burden of this collection of information is estim=
ated
to average less than 10 minutes per person, including the time for reviewing
instructions, 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 bur=
den
to: CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road, MS D-74, Atlant=
a,
GA 30333, ATTN: PRA (0920-0729).
Assurance of Confidentiality - All information which would permit
identification of an individual, a practice, or an establishment will be he=
ld
confidential, will be used for statistical purposes only by NCHS staff,contractors, and agents only when required and =
with
necessary controls, and will not be disclosed or released to other persons
without the consent of the individual or establishment in accordance with
section 308(d) of the Public Health Service Act (42 USC 242m)and the Confid=
ential
Information Protection and Statistical Efficiency Act (PL-107-347).
1.
Please indicate your opinion about the NCHS web site and the information you
obtain from it.
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Strongly agree |
Agree |
Neutral |
Disagree |
Strongly disagree |
N/A |
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Information is eas=
y to
find |
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Information is easy to interpret |
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Information is relevant |
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Information is accurate |
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Information is timely |
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2.
About how many times have you visited the NCHS web site in the last year?
(Please include today's visit in your count.)
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3.
On this occasion, how did you access the NCHS we=
b site?
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4.
Why did you visit the NCHS website today? (Check all that apply)
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5.
Please rate each of the following NCHS services and data products that you =
have
used in the last year.
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Excellent |
Very good |
Good |
Fair |
Poor |
N/A |
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Website |
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Public use microdata
files |
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Print reports/publications |
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Listserv for one or more NCHS surveys |
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E-mail notices about NCHS products |
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Customer service from an NCHS employee by
e-mail, U.S. mail, or telephone |
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6.
From which of the following health care surveys have you obtained informati=
on
in the last year? (Check all that apply)
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7.
From which of the following household surveys have you obtained information=
in
the last year? (Check all that apply)
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8.
Have you obtained birth or death statistics (National Vital Statistics) in =
the
last year?
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9.
How do you use NCHS information? (Check all that apply)
![3D"http://www.surveymonkey.com/img/t.gif"](3D"NCHS2011ConSURVEYAtt.B_files/image002.gif")
How do you use NCHS information? (Check all =
that
apply) Academic research/sc=
hool
project
Health program plann=
ing,
administration or evaluation
To inform/develop po=
licy
or legislation
Media/journalism
Market research/prod=
uct
development
Personal interest
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10.
Please describe any important gaps in the information or data that NCHS
provides.
11.
Which best describes your occupation?
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12.
How would you best describe your organization?
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13.
Other comments:
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