Form 1 E-mail Services

OMB Control No. 0925-0650
Expiration Date 01/31/2015

NIMH E-mail Service
Customer Satisfaction

Public reporting burden for this collection of information is estimated to average 5 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 (0925-0650*). Do not return the completed form to this address.Top of Form

How easy was it for you to locate the NIMH e-mail address?
	Very Easy
	Easy
	Somewhat Easy
	Difficult
	Very Difficult

How timely was the response you received to your inquiry?
	Very Timely
	Timely
	Somewhat Timely
	Delayed
	Very Delayed

How helpful was the information or referral you received?
	Very Helpful
	Helpful
	Somewhat Helpful
	Not Helpful
	Not at all helpful

How satisfied were you with the services you received?
	Very satisfied
	Satisfied
	Somewhat satisfied
	Unsatisfied
	Very unsatisfied

Do you have any suggestions for improving our e-mail services?

If you need to contact NIMH again, what media do you prefer to use? Check all that apply.
	E-mail
	Telephone
	Web/Live Help(online chat)
	Mail
	No preference

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