Form 3 Attachment F: Data Submission Secure Web Site and Inform

Attachment F. Data Submission Secure Web Site and Information Collection Forms

Figure 1. Public/Login or Registration Page – Provides submission information and a link for users to register or log in.

Figure 2 Registration – The registration process is a two step process. First, participants are requested to enter their contact information, identify their role, as a group, practice site or vendor. The second step requires the user to create a unique ID and password. Based on this information, the database submission system automatically sends an email to have them confirm the email address. After confirming the email the account is approved by the system.

Registration Step 1: Provide information

Form Approved

OMB No. 0935-XXXX

Exp. Date XX/XX/20XX

Public reporting burden for this collection of information is estimated to average 5 minutes per response, the estimated time required to complete registration. 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 5600 Fishers Lane, #07W41A, Rockville, MD 20857.

Registration Step 2: Create Username and Password

Form Approved

OMB No. 0935-XXXX

Exp. Date XX/XX/20XX

Figure 3. Home Page. Outlines each of the steps for data submission process.

Figure 4. Submit Questionnaire - Users upload questionnaire documents in MS Word (doc), Adobe Acrobat (pdf) Text (txt) or Rich Text Format (rtf) format to the submission system and identify which type of questionnaire they are submitting. System administrators then review questionnaires and approve/reject the submitted document.

Form Approved

OMB No. 0935-XXXX

Exp. Date XX/XX/20XX

Figure 5. Submit Data File Page – Users upload data files from their local computer. Each file submitted requires information about how the survey was administered. Information such as mode of administration, response rate, fielding period and number sampled are required to complete the submission. Uploaded files are evaluated in real-time to ensure they meet the basic required format. If not, users receive immediate feedback. Once a file is accepted, the data file is loaded it to the database.

Form Approved

OMB No. 0935-XXXX

Exp. Date XX/XX/20XX

Figure 7. View Submission Status – Users can view the status of their account at any time during the submission process for all submissions in their account.

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