Form 1 Stakeholders

Form Approved

OMB No. 0935-0179

Exp. Date XX/XX/20XX

Questions for Stakeholders

Number: approximately 10 -15 stakeholders per report, 300-450/year

Method: electronic survey sent at end of report

1. Using any number 0 to 10 where 0 is the worst possible and 10 is the best possible, what number would you use to rate the experience of giving feedback on this report?

2. Will the final report be useful ? (yes definitely/yes somewhat/no/comments)

3. What else could improve our systematic reviews in the future? ___________________

Public reporting burden for this collection of information is estimated to average 15 minutes per response, the estimated time required to complete the survey. An agency many 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0179) AHRQ, 5600 Fishers Lane, Mail Stop 07W41A, Rockville, MD 20857.

Public reporting burden for this collection of information is estimated to average 15 minutes per response, the estimated time required to complete the survey. An agency many 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-0179) AHRQ, 540 Gaither Road, Room #5036, Rockville, MD 20850.