OMB No. 0915-0212
Expiration: 07/31/2021
	
Public Burden Statement: The purpose of this information collection is to assess end user satisfaction with technical support provided. The information will be used to improve future support provided. 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. The OMB control number for this information collection is 0915-0212 and it is valid until 07/31/2021. This information collection is [voluntary; mandatory (cite authority); or required to obtain or retain a benefit (cite authority)]. [If this information collection includes information protected by any form of confidentiality then explain this confidentiality and cite the authority.] Public reporting burden for this collection of information is estimated to average xx hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or paperwork@hrsa.gov.
List of Analytic Experts Satisfaction Survey
Thanks for working with our team on the MIECHV Developing Strategies to Facilitate Cross-Model Collaboration and Data Sharing project (MODS).
	
Your model recently received a list of analytic experts offered by the MODS team to help you conduct research using your data. We would like to get feedback on the list of analytic experts provided. This survey will only take about five minutes and will be used to improve the resources developed by the MODS Team. If you do not feel you can complete the survey, please forward it to the appropriate colleague. The responses to this survey are confidential. If you have any questions about this survey, please feel free to contact Yuko Ekyalongo at yekyalongo@childtrends.org or 612-223-3331 ex. 23.
		BASIC INFORMATION 
  
	
Today's date
 
  
	
	
Please identify the model you are affiliated with. ChildFirst EHS
	 Family
	Check-Up Family Connects Family Spirit HFA
Family
	Check-Up Family Connects Family Spirit HFA
HIPPY NFP PAT
SafeCare
Other (please specify)
	
If you selected "Other", please specify the model's name.
 
	
		LIST OF ANALYTIC EXPERTS 
  
	
	
	
	 How
	likely will
	your model
	consult any
	experts on
	the	Very likely
	list?	Likely
How
	likely will
	your model
	consult any
	experts on
	the	Very likely
	list?	Likely
Unlikely Very unlikely Not sure
	
Any additional comments or feedback about strengths or ways to improve the list of analytic experts?
 
  
	
	
		SUGGESTIONS FOR
		ADDITIONAL SUPPORT 
  
	
Do you have any suggestions for additional support you would like to receive to conduct research using your data?
 
	
	
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