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Feedback Survey for Disaster Anniversaries Podcast

Thank you for participating in Disaster Anniversaries Webcast. Please take a few minutes to answer the questions below to tell us what you think about this webcast. Your responses will help us continue to enhance the materials we provide.

Participation is completely voluntary. You can choose whether or not to take the feedback form; you can skip any questions or stop without finishing the feedback form. Whether or not you complete the feedback form will not affect any services you receive from SAMHSA DTAC. Click one of the options below. If you click on “Start feedback form now” you are giving SAMHSA DTAC permission to analyze and report on your responses to support making changes and improvement to the webinars and webcasts SAMHSA DTAC provides in order to better meet user needs.

OMB No. 0930-0338
Expiration Date: 01/31/17

Public Burden Statement: 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 project is 0930-0338. Public reporting burden for this collection of information is estimated to average 15 minutes per respondent, per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, 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 SAMHSA Reports Clearance Officer, 5600 Fishers Lane, Room 15E57B, Rockville, Maryland, 20857.

Last Updated: 04/01/2016