Referral Evaluation

OMB Number 3320-0005
Approval Expiry Date: 2/28/15


Thank you for taking the opportunity to provide valuable feedback regarding the Roster of ECR Practitioners. Below you will find a short, four-question survey. We are very appreciative of your comments!

The U.S. Institute for Environmental Conflict Resolution evaluates all of its projects and cases. The U.S. Institute requests your assistance with the evaluation of the Roster Program. Your responses will be used to improve our programs and services. The average estimated reporting burden for this questionnaire is 4 minutes. This estimate includes time for reviewing the instructions and completing the questionnaire. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Institute. Information from this evaluation will not be reported in a way that individuals or organizations can be identified. The Office of Management and Budget control number that is displayed on the cover is currently valid and authorizes this collection of information.

PERSONS WITH DISABILITIES WHO REQUIRE ALTERNATIVE MEANS FOR COMMUNICATION OF PROGRAM EVALUATION INFORMATION SHOULD CONTACT THE U.S. INSTITUTE AT (520) 901-8501.

Question 1

Please indicate your primary reason for conducting this roster search.



Please Specify:


Question 2


Using the scale above, please rate the extent to which you agree with the following statements about the roster.

a. In general, I feel the roster system expedites the process of finding an appropriate practitioner for a user like me.


b. Using the roster system gives me confidence that my short list includes a sufficient array of appropriate practitioners.


c. I would recommend the roster system to others looking for environmental conflict resolution practitioners.


Question 3


Using the scale above, please rate the extent to which you agree with the following statement.

The roster system is a valuable resource.

Please elaborate:


Question 4

Do you have any additional comments that you would like to provide (e.g., comments on how the roster system could be improved to better serve your needs)?