SelfQuery_Flowchart

Sel f - Quer ies Sur vey
Fl owchar t Dr af t JUNE 20 20

OMB Number: 0915-0366; Expiration date: XX/XX/202X

START

Numbers next to boxes indicate number of questions in that module
Shortest path = 24 questions (~ 8 mins)
Longest path = 80 questions (~ 20 mins)

MODULE 1:
Welcome page

1

MODULE 2:
Demographics
Intro

Question 2.1

Medical Service
Provider or
Supplier
(Organization)

Health Care
Practitioner

3

9

MODULE 12:
Organizations Demographics

MODULE 3:
Individuals Demographics

1

1

MODULE 4:
Individuals - Query
intro

YES

MODULE 13:
Organizations Query intro

NO

Question 4.1

NO

Question 13.1
YES

20

1

MODULE 5:
Individuals - Query
experiences

Question 6.1

YES

16

14
MODULE 6:
Report Intro

1

MODULE 14:
Organizations Query
experiences

NO

MODULE 15:
Organizations Report intro

YES

NO

Question 15.1

1

MODULE 7:
Individuals Report
experiences

MODULE 8:
Individuals Dispute intro

YES

Question 8.1

5

1

MODULE 16:
Organizations Report
experiences

NO
YES

7

MODULE 9:
Individuals Dispute
experience

7

11

5

MODULE 17:
Organizations Dispute intro

MODULE 10:
Individuals Perceptions

7

MODULE 18:
Organizations Dispute
experience

Question 17.1

3

NO

MODULE 19:
Organizations Perceptions

MODULE 11:
Individuals Satisfaction with
products and
services

MODULE 21:
NPDB HIPDB
Merger

1
MODULE 23: End
Comments

END

8

MODULE 20:
Organizations Satisfaction with
products and
services