NCI/Office of Communications and Public Liaison |
APPENDIX 9 |
Customer Satisfaction Survey |
OMB
NO: 0925-0208
EXPIRATION
DATE: 02/28/2022
Collection
of this information is authorized by the Public Health Service Act,
Section 411 (42 USC 285a). Rights of study participants
are protected by the Privacy Act of 1974. Participation is
voluntary, and there are no penalties for not participating or
withdrawing from the study at any time. Refusal to
participate will not affect your benefits in any way. The
information collected in this study will be kept private, under the
Privacy Act. Names and other identifiers will not appear
in any report of this study. Information provided will be
combined for all study participants and reported as summaries. You
are being contacted by email to complete this instrument so that we
can assess client satisfaction with services provided by the National
Cancer Institute's Cancer Information Service.
Public
reporting burden for this collection of information is estimated to
average 2 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC
7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0046-17). Do not
return the completed form to this address.
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Thank you for contacting the National Cancer Institute. The following questions help us assess how satisfied you were with the service you received. Your responses are anonymous. Thank you in advance for answering these questions so that we may better serve the public.
Using a scale from 1-10, where 1 means Extremely Dissatisfied and 10 means Extremely Satisfied, how satisfied are you with the assistance you received?
1- Extremely Dissatisfied
2
3
4
5
6
7
8
9
10-Extremely Satisfied
Using a scale from 1-10, where 1 means Extremely Unlikely and 10 means Extremely Likely, how likely are you to contact our service again in the future?
1 -Extremely Unlikely
2
3
4
5
6
7
8
9
10 - Extremely Likely
Are there any comments you would like to leave about the service you received?
Submit
English Phones: https://livehelp.cancer.gov/ci/documents/detail/5/10/12/5d10149b08f9281165f65760271ae91ffa627625
Spanish Phones: https://livehelp.cancer.gov/ci/documents/detail/5/12/12/08f3b330913c1277dfc1885abd899143cd02bfff
English Email: https://livehelp.cancer.gov/ci/documents/detail/5/8/12/45ca9f62c58ab15b9fe123a36b3a420c68eccd66
Spanish Email: https://livehelp.cancer.gov/ci/documents/detail/5/11/12/245cfe1718889dd43ee26d6654e354af8331c668
English LH: https://livehelp.cancer.gov/ci/documents/detail/5/9/12/99f9b0c9af441a03b923f1e3fdd02d88cc0c3a92
Spanish LH: https://livehelp.cancer.gov/ci/documents/detail/5/15/12/46a3781bc6dfdc82f309c8bc39687b788ca573b1
VA Phones: https://livehelp.cancer.gov/ci/documents/detail/5/16/12/cd491660ec409154660288733c9e7e9b364c1a63
VA LH: https://livehelp.cancer.gov/ci/documents/detail/5/17/12/c2b1a2d2b4d242261ce77edecc37034fb7b99485
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | APPENDIX 9 |
Subject | Customer Satisfaction Survey |
Author | Burstyn, Ilene (NIH/NCI) [E] |
File Modified | 0000-00-00 |
File Created | 2022-03-07 |