Form 0917-0036 IHS Website Feedback Form

Public Survey | Feedback
U.S. Department of Health and Human Services
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Indian Health Service

The Federal Health Program for American Indians and Alaska Natives
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1. How often do you visit this website?

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2. Based on today’s visit, how would you rate your website experience overall?
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3. Which of the following best describes the main purpose of your visit?
Browse the site

Complete time and attendance sheet

Find a form

Find a hospital, clinic, or other medical facility

Find a report

Find data sets

Find dental providers in my state

Find out about events

Find out how to report fraud

Find regulations and guidance for health
practitioners

Find information about eligibility for IHS services

Find contact information

Get information about health issues

Get information about grants and funding

Get information about jobs

Get information about standards and policies

Get information about the Resource and Patient
Management System

Learn about opportunities in the health
community

Learn about prevention and wellness

Read the Director's Blog

Read the most recent newsl

Read or download publications

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Other
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None of the above
4. How did you come here today?
Federal Register Notice

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Television or radio

Newspaper or magazine

Friend or colleague

Link from another webiste

Facebook

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YouTube

USAgov

Search Engine (Google, Yahoo, etc)

5. Were you able to complete the purpose of your visit?

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6. How do you prefer to find things (navigate) on the site?
A-Z Index

External Search Engine (example: Google, Bing,
Yahoo)

Website Navigation (top and left-side of page)

Scan the page

Search box on website

Other
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None of the above
7. Which of the following best describes you?
Health professional

Human Services professional

Tribal member

IHS Employee

HHS Employee

Tribal Leader

Tribal Health Facility Employee

Urban Health Facility Employee

Consultant

Non-profit organization

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Teacher

Student

Journalist

Member of the general public

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8. I am:

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9. I am:

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10. My first language is:

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11. My level of schooling is:

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12. I am usually on the Internet, at work, home or school, not including email Select:
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days a
week.

13. I am usually on the Internet, at work, home or school, not including email Select:
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a
day.

14. I access the internet from my mobile phone:

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15. What one thing on this website would you most like to change or fix? (Please do not include personally identifiable information here).

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According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection
is 0917-0036. The time required to complete this information collection is estimated to average 15 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and
complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services,
OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

Indian Health Service (HQ) - The Reyes Building, 801 Thompson Avenue, Rockville MD, 20852

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http://www.ihs.gov/feedbackform/survey/[4/20/2015 2:21:10 PM]

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