Form 1 Survey

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

2023 NIH SGM SIS Customer Feedback_Sessions 1-6

NIH Sexual & Gender Minority (SGM) Health Summer Intensive Series- Customer Feedback: Sessions 1 - 6 (NHGRI)

OMB: 0925-0648

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SGM	SIS	Post	Session	1-6	Feedback
OMB#:	0925-0648	Exp.,	date:	06/30/2024
	
Public	reporting	burden	for	this	collection	of	information	is	estimated	to	average	5-minutes	per
submission.	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	your	participation	at	today’s	session	in	the	Sexual	and	Gender	Health	Research	Summer
Intensive	Series.	
Please	take	a	moment	to	complete	the	following	assessment.	There	are	4	questions.	All	questions	are	optional.	You
may	exit	the	survey	at	any	time.	

1.	For	which	session	are	you	providing	feedback?	
Monday,	June	12
Wednesday,	June	21
Monday,	June	26
Monday,	July	10
Monday,	July	17
Monday,	July	24

2.	What	is	your	current	institution?	
NIH	Bethesda
NIH	off-site
University
Non-Profit
Other	(please	specify)

3.	What	is	your	current	role	at	your	institution?	
Summer	Intern
Postbac
Pre-doc
Early	Investigator
Established	Investigator
Other	(please	specify)

4.	What	improvements	would	you	recommend	for	this	series?	

5.	Please	rate	your	satisfaction	with	today’s	session	on	a	Likert	scale	of	1-5,	with	1	being
Strongly	Agree	to	5	being	Strongly	Disagree:	
	

Strongly	Agree
This	session	was
helpful	to	me.
I	would	recommend
this	session	to	other
trainees.

Agree

Neutral

Disagree

Strongly
Disagree

6.	Please	rate	your	satisfaction	with	today’s	speakers	on	a	Likert	scale	of	1-5,	with	1	being
Strongly	Agree	to	5	being	Strongly	Disagree:	
Strongly
Agree

	
Today’s	speaker	#1
was	knowledgeable,
presented	the
information	in	a	way
I	could	understand,
and	was	engaging.
Today’s	speaker	#2
was	knowledgeable,
presented	the
information	in	a	way
I	could	understand,
and	was	engaging.
Today’s	speaker	#3
was	knowledgeable,
presented	the
information	in	a	way
I	could	understand,
and	was	engaging.
Today’s	speaker	#4
was	knowledgeable,
presented	the
information	in	a	way
I	could	understand,
and	was	engaging.
Today’s	speaker	#5
was	knowledgeable,
presented	the
information	in	a	way
I	could	understand,
and	was	engaging.
Today’s	speaker	#6
was	knowledgeable,
presented	the
information	in	a	way
I	could	understand,
and	was	engaging.

Agree

Neutral

Disagree

Strongly
Disagree

N/A


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File Created2023-05-12

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