EPI-AID Satisfaction Survey for Requesting Official

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

Cover Page

OMB No. 0920­0008 

Thank you for inviting CDC to assist with your recent Epi­Aid investigation. Epi­Aid investigations are meant to provide 
assistance to our public health partners in response to urgent public health problems. They also are one of the most 
valuable applied epidemiology training opportunities for EIS officers and other CDC­sponsored trainees. We hope that you 
(and your staff) found that the Epi­Aid was a productive, informative, and congenial experience.  

To better inform the Epi­Aid process, we are asking you to complete a satisfaction survey. The survey should take less 
than 15 minutes to complete 2 questions about overall satisfaction, response time, team composition, communication, 
and professionalism. You will also have the opportunity to provide open­ended comments.  

Your feedback is an invaluable piece of our Epi­Aid evaluation and will help us to improve the process.  

Scroll down the page and select next to continue.  

Douglas Hamilton, MD, PhD  
CAPT, USPHS 
Chief, Epidemic Intelligence Service (EIS) 

Rachel Avchen, MS, PhD 
CAPT, USPHS 
Associate Chief of Epidemiology, Epidemic Intelligence Service (EIS) 

Mary Dott, MD, MPH 
CDR, USPHS 
Associate Chief of Epidemiology, Epidemic Intelligence Service (EIS) 

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

OVERALL SATISFACTION

*1. What is the Epi­Aid number for which you are providing feedback? If unknown, please

provide the topic and location (state) of the Epi­Aid.

5
6  

2. How satisfied were you with CDC’s response time to your request for an Epi­Aid?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n

Comments:  

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6

3. How satisfied were you with the composition of the Epi­Aid team?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n

Comments: 

5

6

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

4. How satisfied were you with the EIS Officer(s) on the Epi­Aid team?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n

Comments: 

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6

5. How satisfied were you with the medical students on the Epi­Aid team?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n
j Not applicable
k
l
m
n

Comments: 

5

6

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

6. How satisfied were you with the professionalism of the Epi­Aid team?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n

Comments: 

5

6

7. How knowledgeable was the Epi­Aid team about the focus of the investigation?
j Extremely knowledgeable
k
l
m
n
j Very knowledgeable
k
l
m
n

j Moderately knowledgeable
k
l
m
n
j Slightly knowledgeable
k
l
m
n

j Not at all knowledgeable
k
l
m
n

Comments: 

5

6

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Exp. Date 00/00/0000

ATTACHMENT E

8. How willing are you to request another Epi­Aid in the future (if you should need
additional resources to address another outbreak/public health problem)?
j Extremely willing
k
l
m
n
j Very willing
k
l
m
n

j Moderately willing
k
l
m
n
j Slightly willing
k
l
m
n

j Not at all willing
k
l
m
n

Comments: 

5

6

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

SATISFACTION WITH EPI­AID TEAM COMMUNICATION

9. How well did the Epi­Aid team keep you informed about the status of the investigation?
j Extremely well
k
l
m
n
j Very well
k
l
m
n

j Moderately well
k
l
m
n
j Slightly well
k
l
m
n

j Not at all well
k
l
m
n

Comments: 

5

6

10. How satisfied were you with the briefings provided by the Epi­Aid team?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n

Comments: 

5

6

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

11. When did you receive the PRELIMINARY Epi­Aid REPORT?
j Prior to the team departing
k
l
m
n

j 1­7 days after the team departed
k
l
m
n

j 8­14 days after the team departed
k
l
m
n

j 15­31 days after the team departed
k
l
m
n

j More than 1 month after the team departed
k
l
m
n
j No report received
k
l
m
n

Other (please specify) 

5
Other 

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OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

Prelim Rpt Detail

12. How satisfied were you with the TIMELINESS of the PRELIMINARY REPORT provided
by the Epi­Aid team?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n

Comments: 

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13. How satisfied were you with the CONTENT of the PRELIMINARY REPORT provided by
the Epi­Aid team?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n

Comments: 

5

6

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

Final Rpt

14. When did you receive the FINAL Epi­Aid REPORT?
j Prior to the team departing
k
l
m
n

j 1­4 weeks after the team departed
k
l
m
n

j 2­3 months after the team departed
k
l
m
n
j 4­6 months after the team departed
k
l
m
n

j More than 6 months after the team departed
k
l
m
n
j None received
k
l
m
n

Other (please specify) 

5

6

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

Final Rpt detail

15. How satisfied were you with the TIMELINESS of the FINAL REPORT provided by the
Epi­Aid team prior to departure?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n

Comments: 

5

6

16. How satisfied were you with the CONTENT of the FINAL REPORT provided by the Epi­
Aid team?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n

Comments: 

5

6

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

OUTBREAK/PUBLIC HEALTH PROBLEM CONTROL

17. How satisfied were you with the results of this Epi­Aid?
j Extremely satisfied
k
l
m
n
j Very satisfied
k
l
m
n

j Moderately satisfied
k
l
m
n
j Slightly satisfied
k
l
m
n

j Not at all satisfied
k
l
m
n
j Not applicable
k
l
m
n

Comments: 

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18. How helpful do you think the Epi­Aid was in controlling the current outbreak/public
health problem?
j Extremely helpful
k
l
m
n
j Very helpful
k
l
m
n

j Moderately helpful
k
l
m
n
j Slightly helpful
k
l
m
n

j Not at all helpful
k
l
m
n

Comments: 

5

6

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

19. How helpful do you think the Epi­Aid will be in preventing additional outbreaks or
controlling future public health problems?
j Extremely helpful
k
l
m
n
j Very helpful
k
l
m
n

j Moderately helpful
k
l
m
n
j Slightly helpful
k
l
m
n

j Not at all helpful
k
l
m
n

Comments: 

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20. How helpful was this Epi­Aid in reducing public health concern about the
outbreak/public health problem?
j Extremely helpful
k
l
m
n
j Very helpful
k
l
m
n

j Moderately helpful
k
l
m
n
j Slightly helpful
k
l
m
n

j Not at all helpful
k
l
m
n

Comments: 

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6

ATTACHMENT E

CONCLUDING SECTION

OMB No. 09200008
Exp. Date 00/00/0000

21. Do you have suggestions for improving the Epi­Aid process?
j No
k
l
m
n

j Yes
k
l
m
n

Comments: 

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22. Are there any questions you would like us to address?
j No
k
l
m
n

j Yes
k
l
m
n

Comments: 

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23. Please provide any additional comments you have about this Epi­Aid experience.
5

6  

OMB No. 09200008
Exp. Date 00/00/0000

ATTACHMENT E

24. Approximatley how long did it take you to complete this survey?
j Less than 5 minutes
k
l
m
n
j 5­10 minutes
k
l
m
n

j 11­15 minutes
k
l
m
n

j More than 15 minutes
k
l
m
n
j Other (please specify)
k
l
m
n

ATTACHMENT E

OMB No. 09200008
Exp. Date 00/00/0000

Public reporting burden of this collection of information is estimated to average 15 minutes per response, 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 CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS E­11 Atlanta, Georgia 30333; ATTN: 
PRA (0920­0008) 

ATTACHMENT E

Conclusion

OMB No. 09200008
Exp. Date 00/00/0000

Thank you for taking time to complete this survey. 

Your feedback is an invaluable piece of our Epi­Aid evaluation and will help us to improve the process.  

Please feel free to contact the EIS Program (404.498.6110/EIS@cdc.gov) or one of us if you would like to discuss 
anything in more detail.  

Douglas Hamilton, MD, PhD 
CAPT, USPHS 
Chief, Epidemic Intelligence Service (EIS) 
CDC 
dhh0@cdc.gov 
404.498.6167 

Rachel Avchen, MS, PhD 
CAPT, USPHS 
Associate Chief of Epidemiology, Epidemic Intelligence Service (EIS) 
CDC 
rja5@cdc.gov 
404.498.6189 

Mary Dott, MD, MPH 
CDR, USPHS 
Associate Chief of Epidemiology, Epidemic Intelligence Service (EIS) 
CDC 
mud9@cdc.gov 
404.498.6003