Customer Service Satisfaction Assessment of TB Laboratory Site Visits conducted by CDC Laboratory Consultants-Online Survey

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

Appendix 1_Word Version_New Online Survey Instrument

Customer Service Satisfaction Assessment of TB Laboratory Site Visits conducted by CDC Laboratory Consultants-Online Survey

OMB: 0920-1027

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Appendix 1: New Online Survey Instrument

Site Visit Evaluation: Immediate Follow-up

(screen shots of survey content may be displayed with minor differences due to embedded logic)

Recently, a Laboratory Capacity Team (LCT) Consultant from the Centers for Disease Control and Prevention, Division of Tuberculosis Elimination, Laboratory Branch, conducted a site visit at your TB laboratory. LCT would like to invite you to provide feedback on this recent site visit to enhance future site visits.


  1. This was the first TB laboratory site visit I participated in.

☐ Agree

☐ Disagree

☐ Indifferent/No response

  1. In preparation for the site visit, I reviewed the following information:

(Check all that apply)

☐ Past cooperative agreement data

☐ Performance reports/TARs

☐ Previous site visit reports

☐ Past Aggregate Reports

☐ Other (please specify)

Shape1







  1. The length of the recent TB laboratory site visit was…

☐ Too long (if selected, go to Question 4)

☐ Too short (if selected, go to Question 5)

☐ Adequate (if selected, go to Question 6)



  1. Why did you feel the sight visit was too long?

Shape2







  1. Why did you feel the site visit was too short?

Shape3









  1. Reviewing our laboratory’s work allowed discussions to take place that informed or validated current processes, procedures, or algorithms.

☐ Agree

☐ Disagree

☐ Indifferent/No response

  1. Questions that were asked of the laboratory consultant were either answered informatively or the laboratory consultant offered follow-up after returning to the office.

☐ Agree (if selected, go to Question 9)

☐ Disagree (if selected, go to Question 8)

☐ Indifferent/No response (if selected, go to Question 9)

  1. Why do you feel that questions asked of the laboratory consultant were not answered informatively or the laboratory consultant failed to follow-up with you?

Shape4







  1. Overall, the site visit was beneficial and was a good use of time.

☐ Agree

☐ Disagree

☐ Indifferent/No response

  1. Suggestions or recommendations discussed during the site visit were useful and will be considered.

☐ Agree

☐ Disagree

☐ Indifferent/No response

☐ N/A Suggestions or recommendations were not discussed

  1. The joint meeting with the laboratory, TB Control Program, and the Laboratory Consultant was valuable.

☐ Agree (if selected, go to Question 13)

☐ Disagree (if selected, go to Question 12)

☐ Indifferent/No response (if selected, go to Question 13)

☐ N/A. We did not have an opportunity to spend time with the TB Control Program (if selected, go to Question 13)

  1. Why do you believe that the joint meeting between the laboratory, TB Control Program, and the Laboratory Consultant was not valuable?

Shape5







  1. Resources provided during the site visit were useful.

☐ Agree

☐ Disagree

☐ Indifferent/No response

☐ N/A. We did not receive an informational packet.



  1. Additional information and resources that I would have liked to receive during the site visit included:

Shape6











  1. Agenda items or topics that were not discussed during the site visit that should be included are:

Shape7













  1. The site visit may be improved by:

Shape8









  1. Please provide any additional comments about the site visit.

Shape9











File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorYoungblood, Monica (CDC/OID/NCHHSTP)
File Modified0000-00-00
File Created2021-01-14

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