| Survey: |
HRSA NHSC Participant Survey |
| IA#: |
20317 A1 |
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| Date: |
9/27/2018 |
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| SURVEY TYPE: |
Relationship ( tab 4) |
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| Survey Q# |
Type# |
Type Topic |
| INTRO1 |
Custom |
Respondent Backgroud |
| INTRO2a |
Custom |
Respondent Backgroud |
| INTRO2b |
Custom |
Respondent Backgroud |
| INTRO 2c |
Custom |
Respondent Backgroud |
| INTRO3a |
Custom |
Respondent Backgroud |
| INTRO3b |
Custom |
Respondent Backgroud |
| INTRO3c |
Custom |
Respondent Backgroud |
| RET1 |
Custom |
Respondent Backgroud |
| RET2 |
Custom |
Respondent Backgroud |
| RET4 |
Custom |
Respondent Backgroud |
| RET4 |
Custom |
Respondent Backgroud |
| RET5 |
Custom |
Respondent Backgroud |
| RET6 |
Custom |
Respondent Backgroud |
| RET7 |
Custom |
Respondent Backgroud |
| RET8 |
Custom |
Respondent Backgroud |
| RET9 |
Custom |
Respondent Backgroud |
| RET10 |
Custom |
Respondent Backgroud |
| RET11 |
Custom |
Respondent Backgroud |
| RET12 |
Custom |
Respondent Backgroud |
| RET13 |
Custom |
Respondent Backgroud |
| RET14 |
Custom |
Respondent Backgroud |
| RET15 |
Custom |
Respondent Backgroud |
| RET16 |
Custom |
Respondent Backgroud |
| RET17 |
Custom |
Respondent Backgroud |
| RET18 |
Custom |
Respondent Backgroud |
| RET19 |
Custom |
Respondent Backgroud |
| PORT1 |
3 |
Website/Portal |
| PORT2 |
3 |
Website/Portal |
| PORT2a |
3 |
Website/Portal |
| PORT2b |
3 |
Website/Portal |
| PORT2c |
3 |
Website/Portal |
| PORT2d |
3 |
Website/Portal |
| PORT2e |
3 |
Website/Portal |
| PORT2f |
3 |
Website/Portal |
| PORT3 |
3 |
Website/Portal |
| CUST1 |
Custom |
Customer Service |
| CUST2 |
Custom |
Customer Service |
| CUST3 |
Custom |
Customer Service |
| CUST4 |
2 |
Customer Service |
| CUST4a |
2 |
Customer Service |
| CUST4b |
2 |
Customer Service |
| CUST4C |
2 |
Customer Service |
| CUST4d |
2 |
Customer Service |
| CUST4e |
2 |
Customer Service |
| CUST4F |
2 |
Customer Service |
| CUST5 |
Custom |
Suggested Improvements |
| MENT1 |
Custom |
Product/Information/Service Provided |
| MENT2 |
5 |
Product/Information/Service Provided |
| SITE1 |
5 |
Product/Information/Service Provided |
| SITE2 |
Custom |
Product/Information/Service Provided |
| SITE3 |
5 |
Product/Information/Service Provided |
| SITE4 |
5 |
Product/Information/Service Provided |
| OUT1 |
8 |
Future Behaviors |
| OUT2 |
8 |
Future Behaviors |
| OUT3 |
Custom |
Future Behaviors |
| OUT4 |
Custom |
Future Behaviors |
| OUT5 |
8 |
Future Behaviors |
| DEM1 |
Custom |
Demographics |
| DEM2 |
Custom |
Demographics |
| DEM3 |
Custom |
Demographics |
| DEM4 |
Custom |
Demographics |
| DEM5 |
Custom |
Respondent Backgroud |
| DEM6 |
Custom |
Respondent Backgroud |
| DEM7 |
Custom |
Respondent Backgroud |
| DEM8 |
Custom |
Respondent Backgroud |
| DEM9 |
Custom |
Respondent Backgroud |
| DEM10 |
Custom |
Product/Information/Service Provided |
| DEM11 |
Custom |
Product/Information/Service Provided |
| DEM12 |
Custom |
Product/Information/Service Provided |
| DEM13 |
Custom |
Product/Information/Service Provided |
| DEM14 |
Custom |
Product/Information/Service Provided |
| DEM15 |
Custom |
Product/Information/Service Provided |
| DEM16 |
Custom |
Product/Information/Service Provided |
| DEM17 |
Custom |
Product/Information/Service Provided |
| DEM18 |
Custom |
Product/Information/Service Provided |
| DEM19 |
Custom |
Product/Information/Service Provided |
| DEM20 |
Custom |
Product/Information/Service Provided |
| DEM21 |
Custom |
Product/Information/Service Provided |
| DEM22 |
Custom |
Product/Information/Service Provided |
| DEM23 |
Custom |
Product/Information/Service Provided |
| DEM24 |
Custom |
Product/Information/Service Provided |
| DEM25 |
Custom |
Product/Information/Service Provided |
| DEM26 |
Custom |
Respondent Backgroud |