Skip survey header

NIH Violence Workshop Participant Satisfaction Feedback

OMB#: 0925-0648 Exp., date: 06/30/2024

Public reporting burden for this collection of information is estimated to average 10-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 in this workshop. Please take a moment to complete the following assessment.
1. What type of institution do you represent? *This question is required.
2. What was your workshop role? *This question is required.
3. Did you attend the Phase II opening session on May 6, 2021? *This question is required.
Please rate your level of satisfaction with the following aspects of the opening session:
4. Overall Satisfaction:
4. Organization:
4. Information Provided:
4. Did you attend any of the Phase III working group sessions held from June through July 2021? *This question is required.
Please rate your level of satisfaction with the following aspects of the working group sessions:
5. Overall Satisfaction:
5. Organization:
5. Information Provided:
5. Did you attend the Phase IV report-out session held August 26, 2021? *This question is required.
Please rate your level of satisfaction with the following aspects of the report-out session:
6. Overall Satisfaction:
6. Organization:
6. Information Provided:
Please rate your level of satisfaction with the following aspects of the four-phase virtual workshop overall:
6. Overall Satisfaction: *This question is required.
7. Organization: *This question is required.
8. Information Provided: *This question is required.
9. Time Commitment: *This question is required.