OMB Control No. 1601-0014
Expiration Date: 11/20/2021
This survey is anonymous and voluntary and the information collected will be used to improve future DHS CWMD products or services. The “Anonymous Responses” function of the SurveyMonkey website will be enabled during the administration of this information collection survey, disabling the collection of respondent IP addresses. Please do not input any unsolicited PII in your responses.
Paperwork Reduction Act Statement: The public burden for this voluntary collection of information is estimated to be approximately fifteen minutes. An agency may not conduct or sponsor, and persons are not required to respond to a collection of information, unless it displays a valid OMB control number. The OMB control number assigned to this collection is 1601-0014, which expires 11/20/2021. Send comments regarding this burden estimate or collection to:
Daniel Weidinger
245 Murray Lane SW
Mailstop 0315
Washington, DC 20528
MPHISE Assessment Survey Questions
Section 1: Background Information
Instructions: Please respond to the following questions.
Question |
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Section 2: MPHISE Effectiveness Questions
Instructions: Please respond to Questions 4 through 8 by selecting one of the following six options: (1) Very Ineffective, (2) Marginally Effective, (3) Neutral, (4) Somewhat Effective, (5) Very Effective. If the feature in question was Not Observed, please select that option. Question 9 provides explanations of any “Not Observed” entries. For each question, answer “How effective is MPHISE at:”
Statement |
Very Ineffective (1) |
Marginally Ineffective (2) |
Neutral (3) |
Somewhat Effective (4) |
Very Effective (5) |
Not Observed |
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Section 3: MPHISE Ease of Use Questions
Instructions: Please respond to Questions 10 through 16 by selecting one of the following six options: (1) Very Difficult, (2) Difficult, (3) Neutral, (4) Easy, (5) Very Easy, or Not Observed. If the feature in question was Not Observed, please select that option. Question 17 provides explanations of any “Not Observed” entries. For each question, answer “How easy was it to:”
Statement |
Very Difficult (1) |
Difficult (2) |
Neutral (3) |
Easy (4) |
Very Easy (5) |
Not Observed |
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Section 4: Operational Impressions
Instructions: Please respond to the statements in Questions 18 through 22 by selecting one of the following six options: (1) Strongly Disagree, (2) Disagree, (3) Neutral, (4) Agree, (5) Strongly Agree, or Not Observed. If the feature in question was Not Observed, please select that option. Question 23 provides explanations of any “Not Observed” entries. Answer indicate your level of agreement with every statement.
Statement |
Strongly Disagree (1) |
Disagree (2) |
Neutral (3) |
Agree (4) |
Strongly Agree (5) |
Not Observed |
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Section 5: Summary Questions
Instructions: For questions 24-25, please provide narrative responses to the questions (must be unclassified). If you have no remarks, please enter "None" in the response box. For question 26, select one response, and provide an explanation in questions 27 and 28. In question 29, provide any final comments not covered elsewhere in this survey (enter None if you have no further comments). Please answer every question:
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Yes |
Maybe |
No |
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Harrison, Todd (CTR) |
File Modified | 0000-00-00 |
File Created | 2023-08-30 |