1. Have you ever called the West Virginia Poison Center (WVPC)?
Choose one of the following options:
Yes
No (If answering no, skip to question #7)

2. Why did you call the WVPC? Choose one of the following options:
For information only
Following a potential poisoning

3. Was your call answered promptly? Choose one of the following options:
Yes
No

4. How useful was the information provided? Choose one of the following options:
Not Useful
Somewhat Useful
Very Useful
Comments:

5. How satisfied were you with the WVPC service? Choose one of the following options, then skip to question #7):
Not at all satisfied
Somewhat satisfied
Very satisfied
Comments:

6. Reason for not calling the WVPC: (Choose one of the following options)
Never needed WVPC services
Not sure what WVPC does
Know what WVPC does, more comfortable with Emergency Room
Needed to call, couldn't find phone number

7. What is your main reason for visiting our website? Choose one of the following options:
Seek general poison prevention information
Seek general poisoning information
See information about WVPC
Order poison prevention materials
Other (specify)

 

8. Did you find what you were looking for? Choose one of the following options:
Yes
No (If not, what were you looking for?)

9. How did you learn about our website? Choose one of the following options:
Advertised in a WVPC publication
From a local news story
Link from another site
Used a search engine
Other (specify)

 

10. How do you plan to use the information on our website? Choose one of the following options:
Personal use
Education use
Work related use
Other (specify)

 

11. What do you like best about our website?

12. What do you like least about our website?

13. What would you like to see added to our website?

14. If you would like to receive a free poison prevention packet from WVPC, please provide the following mailing  information:
 

QTY	DESCRIPTION

	SHIPPING
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country