Form 1 Rural Health Day survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

RuralHealthDaySurvey_v3

Customer Satisfaction Survey for Rural Health Day 2021 Seminar (NCCIH)

OMB: 0925-0648

Document [pdf]
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Rural Health D ay 2021 Evaluation

OMB#0925-0648
Expiration Date: 06/30/2024

Thank you for attending the 2021 NIH Rural Health Day Seminar, titled "Structural-Level
Determinants of Rural Health Disparities." The NIH Rural Health Committee has an interest
in learning whether we are meeting the needs of the Rural Health Day attendees. If there are
unmet needs or suggestions, the NIH Rural Health Committee may use these data to shape
content and features of future Rural Health Day events. All responses will be kept secure to
the extent permitted by law and no identifiers will be collected. This evaluation will remain
active until November 26th, 2021.
Special Accommodations: Individuals with disabilities who need reasonable
accommodation to participate in this survey should contact the Federal Relay (1-800-8778339) by November 21st.
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2021 NIH Rural Health Dav seminar:

Structural-Level Determinants of Rural Health Disparities
November 18, 2021
11:00 AM - 5:30 P.M ET
NIH Videocast

st1tutes of Health


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File Modified2021-10-22
File Created2021-10-22

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