Center for States Live Chat Survey

Center for States Live Chat Survey

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) The purpose of this information collection is to gather feedback on capacity building products and services to better meet the needs of child welfare professionals. Public reporting burden for this collection of information is estimated to average 1 minute per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The control number for this project is 0970-0401. The control number expires on 5/31/2021. If you have any comments on this collection of information, please contact Beth Claxon, ACF, Administration on Children, Youth and Families (ACYF) by e-mail at [email protected].

Survey Introduction Text 

The Center for States is requesting feedback on the Live Chat feature. Please provide feedback about your experiences today. All information you provide is voluntary and anonymous. If you have any questions, please contact Christine Leicht at [email protected].

1. In which State/Territory/Tribe do you work? (Select One)

[Insert picklist]

2. How would you rate your interaction here today?

[Insert five-star rating scale]

3. Was the information you received today helpful? (Select One)

   1. Yes

   2. No

4. Do you have any additional comments?

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