Form 1 NIDDK Health Information survey

9/26/22, 11:02 AM

NIDDK Health Information Survey

OMB# 0925-0648
Exp. Date: 06/30/2024

NIDDK Health Information Survey
Health Information Survey
Disclaimer: The purpose of the survey is to collect
responses from patients and health providers
regarding their experience with NIDDK health
information via the OCHIN electronic health record
(EHR) system.
Public reporting burden for this collection of
information is estimated to average 3 minutes total,
including the time for reviewing instructions,
searching existing data sources, gathering and
maintaining the data needed, and completing and
reviewing the collection of information. An agency
may 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: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (0925-0648). Do not return
the completed form to this address.

* 1. Please select the health information topic from
the dropdown below that you reviewed before
starting this survey.
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NIDDK Health Information Survey

* 2.
Using the following scale, please rate how helpful
you found the health information provided by the
National Institute of Diabetes and Digestive and
Kidney Diseases (NIDDK)
Not at all
helpful

Not so
helpful

Somewhat
helpful

Very
helpful

Extremely
helpful

Helpful

* 3.
Using the following scale, please rate how easy it
was to understand the health information provided
by NIDDK
Not at all
Not so
Somewhat Very easy Extremely
easy to
easy to
easy to
to
easy to
understand understand understand understand understand

Easy to
understand 

* 4.
Using the following scale, please rate your
experience with the length of the health information
provided by NIDDK
Too Long

Too Short

Length is okay

A
reasonable
length 

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NIDDK Health Information Survey

* 5.
Did receiving the health information provided by
NIDDK improve your visit with your healthcare
provider?
Yes
No
Other (please specify)

* 6.
After reading the health information provided by
NIDDK, do you plan to discuss any of the material
with your healthcare provider in a follow up visit?
Yes
No
Other (please specify)

Done

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