AFIX Quarterly Call Evaluation

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCIRD)

Attachment 1_ AFIX Quarterly Call Evaluation Survey_Screenshots

AFIX Quarterly Call Evaluation

OMB: 0920-1026

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AFIX Quarterly Call Survey
Copy of page: Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

This survey was designed to gather participant feedback on the AFIX Quarterly Calls. The survey should
only take about 8 minutes to complete. We are interested in your opinions about the current call structure
and content and any suggestions you might have to enhance the value of future calls.

This survey is completely anonymous.

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

1

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

1. What is your position?
AFIX Coordinator
Program Manager
AFIX Reviewer
Other (please specify)

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

2

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

2. Calls are currently scheduled to last 2 hours. The length of time is:
Appropriate
Too short
Too long
Not sure

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

3

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

3. Calls are currently scheduled quarterly. How would you like the calls to be scheduled?
I'm fine with quarterly
Bimonthly (every other month)
Biannually (twice a year)
Other (please specify)

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

4

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

4. Have these AFIX Quarterly calls been valuable and relevant to you?
Yes
No
Don't know/not sure

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

5

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

5. Why aren't these calls valuable and relevant to you?

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

6

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

6. What part(s) of the call do you find most useful? Select all that apply.
AFIX updates
CDC guest presentations (e.g. other CDC branch, division, center presentations)
AFIX awardee presentations
Release of new resources
Don't know/not sure
Other (please specify)

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

7

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

7. What presentation/discussion topics interest you for future calls? Select all that apply.
CDC AFIX updates
Awardee AFIX presentations
AFIX promising practices
Annual Report details
Sharing of challenges, practices, and available resources in an effort to enhance collaboration among AFIX Coordinators
None
Don't know/not sure
Other (please specify)

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

8

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

8. The call's slides are posted on the ISD Awardee SharePoint portal. How do you use the slides? Select
all the apply.
I review the slides
I refer staff to the slides when necessary
I use information from the slides for my program's needs
I neither review the slides, refer staff to the slides, nor use the slides for my program's needs
Other (please specify)

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

9

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

9. The call's minutes are posted on both the AFIX website and on SharePoint. How do you use these
minutes? Select all the apply.
I review the minutes
I refer staff to the minutes when necessary
I use information from the minutes for my program's needs
I neither review the minutes, refer staff to the minutes, nor use the minutes for my program's needs
Other (please specify)

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

10

AFIX Quarterly Call Survey
Approved Form
OMB No. 0920-1026
Exp. Date: 07/31/2017

10. We welcome other comments and suggestions for improving the AFIX Quarterly calls:

Public reporting burden of this collection of information is estimated to average 8 minutes per response. 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.
Please 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 Rd., NE (MS D-24); Atlanta, GA 30333; ATTN: PRA
(0920-1026).

11


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File Created2015-08-31

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