Partnership Feedback Survey

Critical Infrastructure Stakeholder
Feedback Survey:
Partnership Feedback
General Information
Date of activity/event/engagement/product
or tool use

Name of activity/event/engagement/product
or tool use

What classification best describes your organization?

Federal Government
State
Private
Other
Territorial
Non-profit
Tribal
Local
government
government
sector State/Territory
Organization’s

Organization’s sector

Alabama

Chemical

American
Alaska
District
Connecticut
Colorado
California
Arkansas
Arizona
Nevada
Nebraska
Montana
Missouri
Mississippi
Minnesota
Michigan
Massachusetts
Maryland
Maine
Louisiana
Kentucky
Kansas
Iowa
Indiana
Illinois
Idaho
Hawaii
Guam
Georgia
Florida
Delaware
New
North
Puerto
Pennsylvania
Oregon
Oklahoma
Ohio
Rhode
South
Virgin
Virginia
Vermont
Utah
Texas
Tennessee
West
Washington
Wyoming
Wisconsin
Hampshire
Jersey
Mexico
York
Virginia
Carolina
Dakota
Carolina
Marianas
Dakota
Island
Islands
Rico
of Samoa
Columbia
Islands
Overall
Assessment

Commercial
Critical
Communications
Defense
Dams
Emergency
Financial
Energy
Food
Government
Healthcare
Informaton
Nuclear
Transportation
Water
and
and
Manufacturing
Reactors,
Industrial
Services
Agriculture
Wastewater
and
Services
Technology
Facilities
Facilities
Systems
Public
Materials,
Health
Systems
and Waste

1 This activity, event, product, or tool was important to foster relationship building and sustain effective partnerships
with other organizations.
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

NA

2 The necessary private and public sector partners were present at the meeting.
Yes

No

NA

If no, who should have attended?

3 This product or tool was easy to use.
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

NA

Disagree

Strongly Disagree

NA

If no, who/what was missing?

4 The information provided was current and relevant.
Strongly Agree

Agree

Neutral

5 My organization is likely to incorporate the information provided into future risk mitigation and resilience
enhancements.
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

NA

6 The information provided will contribute to my organization’s counterterrorism actions, security improvements,
and/or terrorism preparedness planning.
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

NA

7 The amount of time spent on this activity, event, or tool was appropriate for the take-home or outcome.
No—too short

No —too long

NA

8 The process used during this activity or event was effective for the goal.
Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

NA

Strongly Disagree

NA

9 The goal for the activity or event was clear and achievable.
Strongly Agree

Agree

Neutral

Disagree

10 Please provide any recommendations that you may have on how future activities or events of this type could be
improved to enhance their quality and relevance.

11 Please provide any feedback you wish to provide regarding specific speakers or panelists, if applicable.

OMB Control Number: 1670-0027
Expiration Date: 10/31/2017
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