Where are you located? (Please note: SIRM does not share personal information with third parties)
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How would you rate your live chat experience?
(1=Very Poor, 5=Satisfactory, 10=Excellent) |
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| In your opinion, the length of the chat was |
Way too long
Slightly too long
Just right
Slightly too short
Way too short
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| Which time zone do you live in? |
Eastern
Central
Mountain
Pacific
Other, please specify:
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| In your opinion, the start time of the chat was |
Too early
Just right
Too late
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In your opinion, the best time for a chat to start would be
(Please denote AM or PM) |
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| In your opinion, the best day of the week for a chat would be |
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Any day of the week
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| In your opinion, chats should be held |
Once a week
Once every two weeks
Once every three weeks
Other, please specify:
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| Would you prefer chats with open topics (i.e., ask any type of question) a specified topic (e.g., egg donation, embryo transfers, fertility drugs, etc.) or both? |
Open topic
Specified topic
Both
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| If you submitted a question during the chat, did you receive an answer? |
Yes
No
Didn't submit a question
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| If yes, was your answer satisfactory? |
Yes
No
Unsure
Wanted more information
Got too much information
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| How do you connect to the Internet? |
Telephone/modem
Cable modem
DSL
ISDN
Satellite
T1 line
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| What is your operating system? |
Windows 2000/NT/XP
Windows 98/ME
Windows 95
Windows 3.1
Macintosh
Unix/Linux
Other, please specify:
Don't know
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| Which web browser do you use? |
IE 5.x-6.x
IE 4.x or earlier
Netscape 6.x
Netscape 4.x
AOL
Other, please specify:
Don't know
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Did you experience any technical problems during the chat?
(Choose all that apply) |
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Please enter your e-mail address:
(Optional) |
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| Comments? |
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