Form 3320-0003(2) Assessment Services - Assessor Questionnaire (Paper)

OMB Number: 3320-0003
Approval Expiry Date: xx/xx/xxxx

Assessment Evaluation (Assessor)
The U.S. Institute for Environmental Conflict Resolution evaluates all of its services. As a part of this
evaluation we ask the various interests who have been involved in an Institute project or case to provide us
with information about their experience. Your responses will be part of the Institute’s ongoing evaluation
effort, and the data compiled will provide much-needed information that will be used to improve our
programs and services. The average estimated reporting burden for this questionnaire is 6 minutes. This
estimate includes time for reviewing the instructions, completing, and reviewing the questionnaire. Send
comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to the Institute.
1.

How extensive was the situation/conflict assessment?
Check all
that
apply
F

a. One round of telephone interviews with the key parties identified initially

F

b. More than one round of telephone interviews with the key parties identified
initially

F
F
F
F
F
F

c. Telephone interviews with additional parties beyond those identified initially
d. Conference calls with groups of parties
e. In-person interviews with individual parties
f. Meetings with groups of parties
g. Public meetings
h. Administration of special instruments, tools, or techniques (Please Specify)

_______________________________________________________________

2.

How many people were contacted as part of this assessment?
______

3.

Total number of people contacted

Please estimate the number of hours you devoted to this assessment:
______

Total hours

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4.

What was the general recommendation in the assessment regarding whether or not to
proceed with this situation/controversy?
Check only
one
F
F

5.

a. Proceed with one or more of the recommended approaches to collaboration
(e.g., mediation, facilitation, or other approach)

b. Do not proceed with a collaborative process at this time

Was the general recommendation followed?
Check only one
F

Yes, recommendation(s) has been followed or likely will be followed

F

Uncertain

F

No

To the extent you are aware, please identify the key factors that influenced the parties’ decision
on whether or not to proceed with the assessment recommendations:

6.

Was the situation/conflict assessment effort appropriate to the needs of this case?
Check only one

F

Yes

F

No

F

Uncertain

Please elaborate:

7. Please tell us how this assessment could have been improved.

________________________________________________________________________
________________________________________________________________________

THANK YOU FOR TAKING THE TIME TO COMPLETE THIS QUESTIONNAIRE.

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