Self-Queriers Survey: Module 5
Number of questions: 20
Experiences of Self-Querying the NPDB
Q 5.1. How did you access the self-query interface on the NPDB website?
Using the link on the NPDB website
Using a link on a non-NPDB website
Other (please specify) _______________
Q 5.2. Please rate your level of overall satisfaction with self-query.
Rating Scale
Very Satisfied
Satisfied
Neither Satisfied Nor Dissatisfied
Dissatisfied
Very Dissatisfied
Q 5.3. How many times have you performed a self-query in the last 5 years?
1
2
3
4
5 or more
Survey Page Break
Q 5.4. In the past 5 years, whenever you have self-queried, what was/were your reason(s)? (Please select all that apply.)
I was notified that I was the subject of a report in the NPDB
To check if I have any reports in the NPDB
To provide to an employer or a potential employer
To provide to an organization (e.g., hospital, health plan, etc.) for medical staff membership, clinical privileges, and/or panel memberships
To provide to a medical malpractice/liability carrier
To provide to a State Licensing Board
To provide to a Professional Society
To provide to another State Agency
To provide to a Federal Agency
Other (Please Explain) ____________
Q 5.5. Have you ever requested multiple copies of the results from a self-query?
Yes
No Skip to Q 5.7
Other (Please Explain) ____________
Survey Page Break
Q 5.6. For each of the following items, please select the reasons that you requested multiple copies of the self-query results. (Only one answer per row.)
Rating Scale For Each Item
Yes / No
To provide to an employer or a potential employer
To provide to an organization (e.g., hospital, health plan, etc.) for medical staff membership, clinical privileges, and/or panel memberships
To provide to a medical malpractice/liability carrier
To provide to a State Licensing Board
To provide to a Professional Society
To provide to another State Agency
To provide to a Federal Agency
To retain a copy in my own records
Other (Please Explain) _____________
Survey Page Break
Q 5.7. Have you requested a response to be mailed?
Yes
No Skip to Q 5.11
Q 5.8. Were there any difficulties in receiving a mailed response?
Yes (Please Explain) _________
No
Other (Please Explain) ____________
Q 5.9. What were your reasons for requesting a copy to be mailed?
A potential employer requested a hard copy.
I was not able to print an electronic copy.
I was not able to save an electronic copy.
Other (Please Explain) ____________
Q 5.10. Would a digitally signed PDF copy of the report be sufficient instead of a mailed hard copy?
Yes
No (Please Explain) ____________
Do not know
Other (Please Explain) ____________
Survey Page Break
Q 5.11. Have you ever left the process of self-query unfinished?
Yes If yes, go to Q 5.12, otherwise skip to Q 5.13.
No
Unknown
Other (Please Explain) ____________
Q 5.12. What were your reasons for not finishing self-query? (Please select all that apply.)
I did not want to use the online automated identity verification process.
Online automated identity verification process could not identify me.
A Notary was required, which I did not have access to at the time.
The overall self-query process was too hard.
I changed my mind about self-querying in the middle of the process.
Other reason (please explain) _________________
Survey Page Break
Q 5.13. Please rate your level of satisfaction with the NPDB’s online automated identification method for completing a self-query?
Very Satisfied
Satisfied
Neither Satisfied Nor Dissatisfied
Dissatisfied
Very Dissatisfied
Not Applicable (I have never used the NPDB online automated identification) Skip to Q 5.15
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Q 5.14. Please rate your agreement with each of the following statements using the scale provided.
The NPDB’s online automated identity verification method is secure.
The NPDB’s online automated identity verification method is easy to use.
The NPDB’s online automated identity verification method is convenient.
Completely Agree
Agree
Neither Agree Nor Disagree
Disagree
Completely Disagree
Not Applicable (I have never used the NPDB online automated identity verification process)
Survey Page Break
Q 5.15. Please rate your level of satisfaction with NPDB’s Notary identity verification method for completing a self-query?
Very Satisfied
Satisfied
Neither Satisfied Nor Dissatisfied
Dissatisfied
Very Dissatisfied
Not Applicable (I have never used NPDB’s Notary identity verification method) Skip to Q 5.17
Survey Page Break
Q 5.16. Using the scale provided, please rate your agreement with each of the following statements regarding the NPDB’s Notary identification method.
The NPDB’s Notary identity verification method is secure.
The NPDB’s Notary identity verification method is easy to use.
The NPDB’s Notary identity verification method is convenient.
Completely Agree
Agree
Neither Agree Nor Disagree
Disagree
Completely Disagree
Not Applicable (I have never used NPDB’s Notary identity verification method)
Survey Page Break
Q 5.17. The self-query information I received from the NPDB is accurate and complete.
Completely Agree
Agree
Neither Agree Nor Disagree
Disagree
Completely Disagree
Q 5.18. I received a response to the self-query in a timely manner.
Completely Agree
Agree
Neither Agree Nor Disagree
Disagree
Completely Disagree
Survey Page Break
Q 5.19. How would you rate the cost of self-query?
Very Expensive
Expensive
Fair Cost
Inexpensive
Very Inexpensive
Survey Page Break
Q 5.20. Please share any comments regarding your experiences with self-querying the NPDB.
Text box
Piping logic:
Survey will be directed to Module 6.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Microsoft User |
| File Modified | 0000-00-00 |
| File Created | 2021-02-15 |