Form 1 NLM MedlinePlus Google Survey Instrument

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

NLM MedlinePlus Google Survey Instrument (screenshots)

NLM Google Survey for MedlinePlus Page Satisfaction Rating

OMB: 0925-0648

Document [pdf]
Download: pdf | pdf
NLM Google Survey for MedlinePlus Page Satisfaction Rating
One of the following sets of custom questions will be presented to the page visitor:
Question Set 1
1. How likely are you to recommend this page to someone else?
[Multiple choice]
a) Very likely
b) Somewhat likely
c) Not sure
d) Somewhat unlikely
e) Very unlikely

2. Please tell us why:
[Free text response]
Question Set 2
1. How helpful is this web page to you?
[5 star rating selection from “Not helpful” to “Very helpful”]

2. How can we improve this web page?
[Free text response]
Screenshot of the OMB Burden Statement included at the bottom of a MedlinePlus English Health Topic
page:

1

Screenshot of a sample site with the standard Google Survey:

Screenshot of the OMB Burden Statement included at the bottom of a NLM MedlinePlus English
encyclopedia article:

2


File Typeapplication/pdf
File TitleGeneric Clearance Submission Template
SubjectGeneric Clearance Submission Template
AuthorOD/USER
File Modified2016-12-16
File Created2016-12-16

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