Document
Medicaid.gov Pop-up Survey
ICR 202609-0938-011 · OMB 0938-1382 · Object 172935800.
Document Viewer [xlsx]
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | Medicaid.gov Pop-up Survey |
| Author | Moore, Ethan (CMS/CMCS) |
| Last Modified By | Calc |
| File Modified | 2026-04-16 |
| File Created | 2026-10-10 |
| Conversion State | complete |
Extracted Text
Survey Unit Testing Medicaid.gov theme Next button and Back button Compact question spacing Auto advance on pages QID Question Type Question Text BLOCK 1: INTRO We are interested in your opinion to continuously improve our website for you. This short survey will take approximately 2 minutes to complete. Intro Message Descriptive Text Intro Message Descriptive Text All responses to this survey are voluntary and anonymous. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 09381382. This number is valid thru 12/31/2026. BLOCK 2: Default Question Block Q0 Q0.1 Q1 PAGE BREAK This question will record the recipient's browser information. It will not be displayed to the user. - Browser Type - Browser Version - Operating System Descriptive - Screen Resolution Text - User Agent This question lets you record and manage how long a participant spends on this Descriptive page. This question will not be displayed to the participant. Text Based on my experience on Medicaid.gov, Multiple Choice I trust that Medicaid is working in the (single select) best interest of the American public. Q2 Multiple Choice (single select) Which of these best describes you? PAGE BREAK Q3 What was the main reason you came to Medicaid.gov today? If you came for more Multiple Choice than one reason, please pick the main (single select) one. PAGE BREAK Q4 Multiple Choice What about today's interaction made the (multi-select) difference? (Select all that apply) PAGE BREAK Q5 Multiple Choice How satisfied are you with your overall (single select) experience on Medicaid.gov? Block 3 - Open Text Q6 Text Entry How can weyou improve yourtime overall experience on Medicaid.gov? Please be specific, but prote We thank for your spent taking this survey. END OF SURVEY Your response has been recorded. Testing Medicaid.gov theme Next button and Back button Compact question spacing Auto advance on pages Answer Choices (if applicable) NA NA N/A N/A Yes No I Have or am Applying for Medicaid I am a Caregiver, Friend, or Family Member Healthcare Professional Government Employee Researcher of Policy Analyst None of These Apply (Please specify) (open text box) Medicaid eligibility or coverage information Federal policy or regulatory guidance CHIP information Data Resources for states Other (Please specify) Accomplishing my task Website navigation Find what I need Able to understand the information Something else (open text box) Extremely dissatisfied Slightly dissatisfied Neither satisfied nor dissatisfied Slightly satisfied Extremely satisfied spent taking this survey. URVEY been recorded. Open text box