Form FSR 210 FSR 210 SAMHSA NCAID and Mental Health

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Overview

Model Qsts
Custom Qsts

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Sheet 1: Model Qsts

FORESEE RESULTS MODEL QUESTIONS SAMHSA NCADI and Mental Health Model questions utilize the ACSI methodology to determine scores and impacts
ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
All questions under each element are required. Element questions are partitioned among surveys.		Satisfaction questions are required. Satisfaction questions appear on all surveys.		Future behaviors may be modified based on your site's objectives. Future behavior questions appear on all surveys.
Content (1=Poor, 10=Excellent, Don't Know)		Satisfaction (1=Poor, 10=Excellent)		Likelihood to Return (1=Not Very Likely, 10=Very Likely)
Please rate the accuracy of information on this site.		What is your overall satisfaction with this site?		How likely are you to return to this site?
Please rate the quality of information on this site.		How well does this site meet your expectations?		Recommend (1=Not Very Likely, 10=Very Likely)
Please rate the freshness of content on this site.		How does this site compare to your idea of an ideal website?		How likely are you to recommend this site to someone else?
Functionality (1=Poor, 10=Excellent, Don't Know)				Primary Resource (1=Not Very Likely, 10=Very Likely)
Please rate the usefulness of the services provided on this site.				How likely are you to use this site as your primary resource for obtaining information from this organization?
Please rate the convenience of the services on this site.				Likelihood to Download & View (1=Not Very Likely, 10=Very Likely)
Please rate the ability to accomplish what you wanted to on this site.				How likely are you to download and/or view publications from this site?
Look and Feel (1=Poor, 10=Excellent, Don't Know)				Likelihood to Order Publications (1=Not Very Likely, 10=Very Likely)
Please rate the visual appeal of the site.				How likely are you to order publications from this site?
Please rate the amount of graphics and text on each page of the site.
Please rate the ease of reading the pages on this site.
Navigation (1=Poor, 10=Excellent, Don't Know)
Please rate how well the site is organized.
Please rate the options that are available for you to navigate on this site.
Please rate how well the site layout helps you find what you are looking for.
Please rate the number of clicks to get where you want on this site.
Search (1=Poor, 10=Excellent, Don't Know)
Please rate the relevance of search results on this site.
Please rate the organization of search results on this site.
Please rate how well the search results help you decide what to select.
Please rate how well the search feature helps you to narrow the results to find what you want.
Site Performance (1=Poor, 10=Excellent, Don't Know)
Please rate the speed that pages load on this site.
Please rate the consistency of speed from page-to-page on this site.
Please rate the ability to load pages without getting errors on this site.
Ordering Process (1=Poor, 10=Excellent, Don't Know)
Please rate the ease of ordering on this site.
Please rate the variety of shipping options on this site.
Please rate the variety of payment options on this site.
Please rate the clarity of order summary information provided to you during the checkout process.
Please rate the security of the ordering process on this site.
Tasks/ Transactions (1=Poor, 10=Excellent, Don't Know)
Please rate the ease of completing task(s) on this site.
Please rate the degree of privacy in completing tasks on this site.
Please rate the verification of task completion on this site.
Please rate the availability of help with questions or problems on this site.
*Please See Next Tab for Recommended Custom Questions

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Sheet 2: Custom Qsts

CUSTOM QUESTIONS SAMHSA NCADI and Mental Health Custom questions complement the model questions and allow for additional data analysis
Question Text	Answer Choices (limited to 50 characters)	Type drop-down menu check boxes radio buttons open-ended	Required Y/N	Select one or all that apply
How frequently do you visit this site?	First time Daily More than once a day About once a week About once a month Every 6 months or less	Drop-down menu	Y	select one
Which of the following best describes your role when visiting this site?	Criminal Justice/Legal Professional Educator/School Employer Faith Community Government (Federal, State, Local) Library/Information/Resource Center Managed Care/Insurance Org. Media Non-Profit/Community-Based Org/Coalition Personal Interest/Family/Friend Policy/Advocacy Org. Researcher SAMHSA Staff Student Substance Abuse/Mental Health Professional Other Health Professional Other	Drop-down menu	Y	select one
If you answered "Other" to the question above, please describe your role below.		Open-ended	N
Which of the following is the reason for your current visit to the website?	Find information on a specific drug Research information by audience Research information by issues/topic Get help for mental health problems Find a mental health facility Information on children's health Find a prevention program Find a drug treatment program Latest national drug abuse surveys/statistics and data Order publications for myself or my family Order publications for my organization Get latest news/press releases Grants or funding opportunities Sign up for email updates Find phone/email contact information Other	Drop-down menu	Y	select one
Did you find what you were looking for?	Yes No Partially Still looking	Radio buttons	Y	select one
If you could not find what you were looking for, what was it?		Open-ended	N
How do you prefer to access SAMHSA's publications and other information?	Online and place order to receive hard copies by mail Online and view web page (ex. - HTML format) Online and print (ex. - download PDF version or printer-friendly format) Call and speak to an Information Specialist Send an email to request information or ask a question Other	Radio buttons	Y	Select One
If you selected "Other" to the question above, please describe how you would like to access SAMHSA's publications and other information.		Open-ended	N
If you could improve one thing about this site, what would it be?		Open-ended	N