Form QID Telephone Quality Control Reinterview Form

OMB No. 0535-0213 Approval Expires: 03/31/2014
			NATIONAL AGRICULTURAL STATISTICS SERVICE

TELEPHONE Quality control REINTERVIEw Form

Supervisor: __________________________________ Callback Date: ___________________________________

Survey Name: ________________________________ Farm, Ranch, or

Survey Month : _____________Year: _____________ Operation Name: _________________________________

State: ______________________________________ Operator’s Name:_________________________________

ID/POID: ___________________________________ Address:_______________________________________

Enumerator: _________________________________ _______________________________________

Interview Date: _______________________________ _______________________________________

Telephone:_____________________________________

Survey Respondent Name: _____________________ Current Respondent Name: ________________________

(Check one) (Check one)

Operator/Manager Operator/Manager

Spouse Spouse

Accountant/Bookeeper Accountant/Bookeeper

Partner Partner

Other Other

INTRODUCTION: [Introduce yourself and ask for the survey respondent.]

1. Recently, you should have been contacted by one of our enumerators, Mr./Mrs. _________________ for the purpose of

obtaining information about your farming or ranching operation for our _________________________Survey. Do you

recall this interview?

Yes – [Go to item 2]

No – [Conclude interview; Go to Field Supervisor Instruction]

Don’t Remember – [Conclude interview; Go to Field Supervisor Instruction]

2. For quality control purposes, I would like to ask you a few brief questions to verify the interview with our enumerator.

Your response is voluntary and not required by law, but your cooperation is greatly appreciated. Did the Enumerator

conducting the interview ask you to verify the spelling of your name, address, and the operation name?

Yes

No

Don’t Remember

Minutes

3. Approximately how long did the interview take? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Did the Enumerator conduct the interview in a knowledgeable and professional manner?

Yes

No – Explain: ____________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

5. Did the Enumerator conduct the interview in person or by phone?

In Person – [Continue]

Phone – [Go to item 6]

1. Did the Enumerator use a tablet/ laptop or a paper questionnaire to collect the information?

Tablet/laptop – [Continue]

Paper Questionnaire – [Go to item 6]

2. Did the Enumerator experience any problems using the tablet/laptop?

Yes – Explain: ________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

No

6. Do you have any additional comments you would like to make concerning the interview with our Enumerator?

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

This concludes the interview. Thank you for your time and feedback.

FIELD SUPERVISOR INSTRUCTION: After you conclude the interview, answer the following question about the quality

control callback.

7. Based on the callback results, did the enumerator conduct the interview satisfactorily?

Yes

No – Explain below

Inconclusive – Explain below

____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Additional comments:

____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Signature: ___________________________________ Date: ______________________________

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