17AIX Attachment C - APPLETREE Post Meeting Survey_text

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

Attachment C - APPLETREE Post Meeting Survey_text

Post-Meeti Survey of attendees at the APPLETREE Meeting 2017

OMB: 0923-0047

Document [docx]
Download: docx | pdf


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Form Approved

OMB No. 0923-0047

Exp. Date: 12/31/2018



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CDC estimates the average public reporting burden for this collection of information as approximately 10 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 collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden statement or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ ATSDR Reports Clearance Officer, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0923-0047).

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  1. Are you a Federal or State employee?


Federal State Neither


  1. Overall, how would you rate the APPLETREE Meeting?


Excellent Very good Good

Fair Poor


  1. How well were logistics (transportation/hotel) for the Meeting organized?


Extremely organized Very organized Somewhat organized Not so organized

Not at all organized



  1. Was Meeting length too long, too short, or about right?


Much too long Somewhat too long About right Somewhat too short Much too short


  1. Do you agree or disagree with the following statements?

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Communication by ATSDR prior to the Meeting was adequate.



Strongly Agree Agree


Not Applicable, or

Neutral Disagree Strongly Disagree




The Meeting agenda was well thought-out and organized.


Strongly Agree Agree



Not Applicable, or

Neutral Disagree Strongly Disagree


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The "Safe-Siting" presentations were helpful and of value to my program.

The Track Sessions allowed me to

participate in

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discussions relevant to my job/role.

The Health Education

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Track topics were relevant and of interest

The Program Evaluation presentation was helpful and of value to my program.

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As a result of the Program Evaluation presentation, I have a

better understanding of

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how to prepare an evaluation strategy for my program.




I feel like I had adequate access to my TPO, Management, and other ATSDR staff.


Strongly Agree Agree



Not Applicable, or

Neutral Disagree Strongly Disagree



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  1. What do you consider to be the most valuable aspect of the APPLETREE Meeting?


Shape14 Shape15 Shape16 Gaining topical awareness on science/policy issues Networking with other states

Shape17 Shape18 Networking and face time with ATSDR management and staff Providing direct input and feedback to ATSDR

This meeting is of little value to me


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Other (please specify)


  1. Please rate the following


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Good Satisfactory Needs Improvement

Hotel location

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Small Group Time

State showcase time

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    Is there anything else you’d like to share about Meeting?

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleView Survey
AuthorLeCoultre, Trent D. (ATSDR/DCHI/OD)
File Modified0000-00-00
File Created2021-01-22

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