Form 1 Mockup Furniture Survey Card

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

040418-PRA-RKL 1-2 Mockup Furniture Survey Card-updated.pptx

Rockledge 1 and 2 Furniture Mockup Feedback

OMB: 0925-0642

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Welcome to the Rockledge I/II Mockup

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Casegoods (Office Furniture) Survey Card

<number>

Category

Haworth

Herman Miller

Teknion

Construction: Quality of product line details

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Construction: Quality of glazed panel option(s)

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Flexibility: Overhead storage options

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Flexibility: Utilizes “kit of parts”

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Flexibility: Functionality of storage components

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Flexibility: Functionality of adjustable & movable components

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Technology: Power/data at the work surface

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Technology: Accessibility to outlets below work surface

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Wire Management: Ease of accessibility

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Wire Management: User-friendliness

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

 

Systems Furniture (Workstation) Survey Card

<number>

Category

Haworth

Herman Miller

Teknion

Construction: Quality of product line details

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Construction: Quality of glazed panel option(s)

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Flexibility: Overhead storage options

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Flexibility: Utilizes “kit of parts”

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Flexibility: Functionality of storage components

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Flexibility: Functionality of adjustable & movable components

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Technology: Power/data at the work surface

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Technology: Accessibility to outlets below work surface

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Wire Management: Ease of accessibility

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Wire Management: User-friendliness

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

<number>

<number>

 

Task Seating Criteria

 

<number>

Task Seating – Standard Survey Card

Features

Haworth

Herman Miller

Humanscale

Teknion

Overall Construction

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Ergonomic Design

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Seat Height Adjustment

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Seat Depth Adjustment

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Lumbar Support

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Tilt Function

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Arm Style

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Arm Adjustment

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Base/Wheels

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

180 degree rotation

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

 

<number>

Task Seating – Executive Survey Card

Features

Haworth

Herman Miller

Humanscale

Teknion

Overall Construction

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Ergonomic Design

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Seat Height Adjustment

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Seat Depth Adjustment

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Lumbar Support

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Tilt Function

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Arm Style

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Arm Adjustment

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

Base/Wheels

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

180 degree rotation

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

1   2   3   4   5  NA

 

Accessories Survey Card

<number>

Category

Haworth

Herman Miller

Humanscale

Teknion

Task Light

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Monitor Arm

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Keyboard Tray

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Sit-Stand Desk

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

Guest Chair

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

 

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

 

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

1   2   3   4   5   NA

 

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  • Burden Disclosure 

  • Public reporting burden for this collection of information is estimated to average 5 minutes or less per response including the time for reviewing instructions. 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 burden, to NIH Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN:  PRA.  OMB#0925-0642.  Do not return the completed form to this address.   

 
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