Document
Survey: Crosswalk
ICR 202609-0938-011 · OMB 0938-1382 · Object 172934700.
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| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | Survey: Crosswalk |
| Author | Tess Hines |
| Last Modified By | Calc |
| File Modified | 2026-04-16 |
| File Created | 2026-10-10 |
| Conversion State | complete |
Extracted Text
CMS 10911 - Medicaid.gov Feedback Tool Question Number Current Question Version Current Answer(s) Version Future Question Version Question 1 - - "Based on my experience on Medicaid.gov, I trust that Medicaid.gov is working in the best interest of the American public. " Question 2 "Which of these best describes you?" Person looking for Helth Insurance information Person using "Find a Dental Provider" tool Healthcare professional or administrative staff Government employee Community outreach partner Other (Please specify) [open text] "Which of these best describes you?" Question 3 "How satisfied are you with your overall experience Extremely dissatisfied on Medicaid.gov?" Slightly dissatisfied Neither satisfied nor dissatisfied Slightly satisfied Extremely satisfied "How can we improve your overall experience on [open text] Medicaid.gov? "How satisfied are you with your overall experience on Medicaid.gov?" Please be specific, but protect your privacy - don't include personal information, like your phone number, address, or Social Security number." [only shows if answer to Question 1 = "Yes"] Please be specific, but protect your privacy - don't include personal information, like your phone number, address, or Social Security number." Question 4 "How can we improve your overall experience on Medicaid.gov? dicaid.gov Feedback Tool Future Answer(s) Version Type of Change(s) from Description of Change from Current to Current to Future Version Future Version Yes/No [single select, required] Addition to survey - consistent Addition to survey - consistent with with Medicaid.gov Feedback Medicaid.gov and A-11 and HISP survey tool requirements I Have or am Applying for Medicaid I am a Caregiver, Friend, or Family Member Healthcare Professional Government Employee Researcher or Policy Analyst None of These Apply (Please specify) (open text box) Extremely dissatisfied Slightly dissatisfied Neither satisfied nor dissatisfied Slightly satisfied Extremely satisfied [open text] Revision to future answers Minor wording changes to existing categories are being made based on user feedback and industry best practices No burden implications No change No change No burden implications No change No change No burden implications Burden Implications Minimal addition of burden by adding one Yes/No question