Form 65 CIRB Satisfaction survey

OMB # 0925-xxxx
Expiration Date xx/xx/xxxx

NCI CIRB Helpdesk Survey

OMB #0925-0625
Expiry Date: 12/31/2016
Public reporting burden for this collection of information is estimated to average 15 minutes per

response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, 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 burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974,
Bethesda, MD 20892-7974, ATTN: PRA (0925-0625). Do not return the completed form to this
address.

________________________

Please complete this short survey for the NCI CIRB. Your feedback will help us with our quality
improvement efforts. Thank you.
1. Based on your Helpdesk interaction, how would you rate the following:
Very Satisfied

Satisfied

Not Satisfied

Response time to your
inquiry
Completeness of
response
Overall Helpdesk
interaction
Comments

2. Do you have any suggestions to improve future Helpdesk interactions?

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3. Please select the team member with whom you communicated. (Select all that apply)
Jen Berghers

LaTisa Hernandez

Allison Peel

Giuliana Brancaccio

John Horigan

Amanda Putnick

Amparo Briggs

Brandon Jonson

Birdena Samuel

Brian Campbell

Kundan Kumar

Jacquie Steenbakker

Laura Covington

Emmett Lauer

Catherine Tuggle

Jennifer Dugan

Dee Miles

Claudine Valmonte

Kate Franklin

Angela Norman

Michelle Weeks

Kituria Gaines

Andrew O'Connor

Don't Know

Renee Green

Diana Orr

4. Please indicate your role.
IRB Staff

Principal Investigator

Research Staff

Cooperative Group Staff

Other (please specify)

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