*1.Have you tried to reach the NHIIS Support Team, the Accountability Team or the Quality Assurance Team in the past year for some type of assistance?

(Required.)

Yes

No

*2.If the above answer was yes, who did you reach out to? (Please select all that you have reached out to)(Required.)

NHIIS Support

Vaccine Accountability (Lena or Abby)

Quality Assurance (Nurses, Lori or Rachel)

Not Applicable

Not Sure

3.Can you please give a brief description of why you needed to reach out to any of these teams?

4.Was your issue resolved in a timely manner?

Yes

No

*5.Did you reach out to these teams via email, phone or both?(Required.)

Phone

Email

Both

Not applicable

6.Moving forward, do you think it would help you to have one phone number for all three teams and you would just have to press the correct number to be automatically directed to the right department?

Yes

No

7.Would it be helpful to have staff changes available within the NHIIS or continue to provide them in a PDF/email communication?

Keep it in PDF form

Allow Staff Change Requests within NHIIS

Either way is acceptable

8.How would you rate the current trainings provided to you through CDC Train?

1 star

2 stars

3 stars

4 stars

5 stars

9.If you rated less than 4 stars from the above question, could you please provide us with some insight on how to improve the trainings or what was the difficulty with them?

10.Please provide us with any additional thoughts or advice on how we can better assist you going into the New Year. Thank you for your time!

11.Please leave your name and contact information if you would like us to follow up with you with any questions or concerns you may have.

Name

Organization/Clinic

Email Address

Phone Number