EXAMPLE SURVEY

Welcome to the Medicaid Administrative Claiming Survey.

Name: <firstname> <lastname>

Survey:

Thanks for taking the time to fill out this survey, <firstname> <lastname>. You should have received training on how to take this survey, but provided below is a short summary of the features and interface of this form to make your time filling it out as short and simple as possible.

• To start, simply select the time you arrived at work from the list of times on the right.
• Then just select the appropriate category from the list on the left.
• The time will automatically advance to the next increment, allowing you to simply click through your day.
• The list of times will change to indicate those times you have filled out, along with the form at the bottom.
• If you feel more comfortable using the form itself, feel free to do so.
• You may save your answers at any time by clicking "Save Survey" and come back to finish it later by loading your previous answers (by clicking "Retrieve Previous Answers").
• To make entering long periods of the same category easier, you may select a range of times from the list by clicking the start time, holding Shift and clicking the end time.
• When you select a category all of the selected times will be set to that category and the time will advance to the next unset category.
• When you are finished simply save the survey and you're done!