9 Webinar Survey

OMB No: 0906-0084

Expiration date: 02/28/2027

Webinar Survey

Public Burden Statement: The purpose of this information collection request is to assess participant satisfaction with various training and TA activities offered through a contracted TA provider, the Education Development Center. 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. The OMB control number for this project is 0906-0084 and is valid until 02/28/2027. This information collection is voluntary. All responses will be aggregated and respondents will remain confidential. Public reporting burden for this collection of information is estimated to average .08 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Information Collection Clearance Officer, 5600 Fishers Lane, Room 14N39, Rockville, Maryland, 20857 or paperwork@hrsa.gov.

1. How satisfied were you with [title] webinar?

   1. Extremely satisfied

   2. Satisfied

   3. Dissatisfied

   4. Extremely dissatisfied

2. [If chosen “Dissatisfied” or “Extremely dissatisfied”] Please explain why you were dissatisfied with the webinar: [Open text]

3. What was the MOST helpful feature(s) of the webinar? Please select all that apply.

   1. Presenter

   2. Content provided

   3. Opportunity to connect with peers

   4. Other, please explain:

4. What was the LEAST helpful feature(s) of the webinar? Please select all that apply.

   1. Presenter

   2. Content provided

   3. Opportunity to connect with peers

   4. Other, please explain:

5. How can we improve future webinars? [Open text]

6. Please rate your agreement with the following statement: This webinar integrated diversity, equity, and inclusion into the content it provided.

   1. Strongly agree

   2. Agree

   3. Disagree

   4. Strongly disagree

7. To what extent did you see diversity, equity, and inclusion show up in the approach of the webinar, including the way it was set up and the language presenters used?

   1. To a great extent

   2. Somewhat

   3. Very little

   4. Not at all

8. Please comment with any suggestions for how we can improve our technical assistance to more intentionally integrate diversity, equity, and inclusion.