Form 64 OPEN survey

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

Attachment_C03_OPENsurvey

Public
reporting
burden
collection
of information
is estimated
to average
minutes
Public reporting
burden
for for
thisthis
collection
of information
is estimated
to vary from
10 to 1515
minutes
per per
response,
response,
including
the time for
reviewing
instructions,
existing
dataand
sources,
gathering
and
including the
time for reviewing
instructions,
searching
existingsearching
data sources,
gathering
maintaining
the data
maintaining
the data needed,
and completing
reviewing the
information.
An agency
needed, and completing
and reviewing
the collectionand
of information.
An collection
agency mayofnot
conduct or sponsor,
and
may
not
conduct
or
sponsor,
and
a
person
is
not
required
to
respond
to,
a
collection
of
information
a person is not required to respond to, a collection of information unless it displays a currently valid OMB
unless
it displays a currently valid OMB control number. Send comments regarding this burden
control number. Send comments regarding this burden estimate or any other aspect of this collection of
estimate or any other aspect of this collection of information, including suggestions for reducing this
information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge
burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974,
Drive, MSC
Bethesda,
20892-7974,
PRA (0925-0624).
Doaddress.
not return the completed form to this
ATTN:
PRA7974,
(0925-xxxx).
DoMD
not
return theATTN:
completed
form to this
address

Oncology Patient Enrollment Network Survey
1

The navigation and the use of the screen functions were
clear.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree

2

Additional suggestions or comments regarding navigation
and screen functions:

3

The "Create New" screen was clear and easy to use.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I do not have access to this screen
1

Attachment _4_opensurvey

OMB #: 0925-0624
Expiry Date: 12/31/2013

4

Additional suggestions or comments regarding the "Create
New" screen:

5

The "Demography" screen was clear and easy to use.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Not available for my protocol
I do not have access to this screen

6

Additional suggestions or comments regarding the
"Demography" screen:

7

The "Checklist" screen was clear and easy to use.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I do not have access to this screen

2

Attachment _4_opensurvey

OMB #: 0925-0624
Expiry Date: 12/31/2013

8

Additional suggestions or comments regarding the checklist
screen:

9

The OPEN system overall was easy to use.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree

10 Was the Training Video helpful in providing the information
you needed to perform an enrollment?
Yes
No
N/A (I did not view it)

11 If no, what information should be added or clarified?

12 Was the User Guide helpful in providing the information you
needed to perform an enrollment?
Yes
No
N/A (I did not use it)

3

Attachment _4_opensurvey

OMB #: 0925-0624
Expiry Date: 12/31/2013

13
If no, what information should be added or clarified?

14

Other comments or suggestions:

4