Form 1 Survey

Background Information

OMB No.: 0925-0648
Expiration Date: 05/31/2021

Collection of this information is authorized by The Public Health Service Act, Section 411 (42 USC 285a). Rights of
participants are protected by The Privacy Act of 1974. Participation is voluntary, and there are no penalties for not
participating or withdrawing at any time. Refusal to participate will not affect your benefits in any way. The information
collected will be kept private to the extent provided by law. Names and other identifiers will not appear in any report.
Information provided will be combined for all participants and reported as summaries. You are being contacted by online to
complete this form so that NIH can improve its editing service.

Public reporting burden for this collection of information is estimated to average 7 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 (0925-0648). Do not return the
completed form to this address.

Thank you for using the NIH Library Editing Service. Please help us evaluate the service by
completing this survey. Please note that your responses are anonymous. This evaluation should
take less than 5 minutes to complete.
* 1. What is the name of the editor who helped you?

* 2. What is your Institute or Center?

3. Please select the area that best fits your primary role.
Affiliate (student, fellow, trainee, etc.)
Clinical Staff
Extramural Grants Management
Intramural Research
Laboratory Technician
Legal / Business Development / Technology Transfer
Scientific Administration / Policy / Analyst
Other (please specify)

Evaluation Information

* 4. Please provide feedback
Poor
Clarity of editor's suggestions
Timeliness of editor's responses

Fair

Good

Very Good Excellent

N/A

Overall Satisfaction

* 5. How satisfied were you with the editing service you received?
Very Dissatisfied

Dissatisfied

Neutral

Satisfied

Very Satisfied

* 6. Thank you for your feedback. How can we improve our editing service to make it better for you?

* 7. How likely are you to recommend this editing service to your colleagues?
Very Unlikely
Recommendation to
colleagues:

Not likely

Neutral

Likely

Very Likely

8. What else can you tell us about your editing needs or our Editing Service?

9. If you would like to be contacted to discuss your editing experience, please provide your contact
information below.
Name
Email Address
Phone Number