1. The questionnaire is available online at: http://dpq.xetex.com/ Select your clinic from the drop down menu. Type in your password and click “Login and Take Questionnaire.” Please email Susan Cheng at wscheng@ucdavis.edu for the password for your clinic. Anyone with your clinic password can start or stop or complete the questionnaire, so more than one person can help to complete it. You can start or stop at any time, there is no need to complete it all at once. Pages can be printed from a printer to work on it offline, just like any other webpage.

2. This is what the questionnaire looks like. Here are a few key features: • Last year’s responses are already put into the questionnaire for you. • If there is no change to last year’s response, just click “Keep” • You have to click “save progress” before leaving this window to save the work you have done • You can always go back and change a response even after you have clicked “keep” or responded • Green means complete – every question on every page has to be green in order for the questionnaire to be considered “complete” and submitted • Anyone can work on the questionnaire as long as they have the clinic password • You start and stop the questionnaire as many times as you like • You can move between pages (1-7) as often as you like • There is a glossary to help with any unfamiliar terms • We are here to help! Feel free to contact us with any questions.

3. Yes No Don’t Know Question 9a Look at Question 9a (arrows are pointing to it) Last year’s response was “N” (“no”), which is already filled in. If there are no changes, then click “keep” button (marked by a star here) and field will turn green (see on the right screen). If the response has changed to “Y” (“yes”) or “DK” (“don’t know”) then just click on the round buttons (next to the arrow) and the question will turn green. When the question turns green, it is considered complete and you can move on. When all questions are green (complete) on the entire questionnaire, on EVERY page, you will be done.

4. This page is not considered complete. Why not? If you look, Question 10a and Question 13a are still white/grey and not yet green. Once you fill in the response to these two questions, they will turn green and the page will be considered complete. If you have no comment (like for question 10a), then just right “no comment” or “n/a” or “none,” but it cannot remain blank. See the next page for a completed sign.

5. These are the pages, 1-7. This page is now complete. When all 7 pages are complete, then you will receive a note that the questionnaire is now considered completed and has been submitted. You can skip around between the pages and you can return to any page, even after you have completed it and received this sign to the left. So you can always go back to change a response, until the questionnaire is completely done and is submitted. Then no more responses can be changed.

6. Other Features: Logout and Save Progress and Glossary Other Features Logout – anyone can start or stop this questionnaire as often as needed. It does not need to be completed all at once. As long as you have the password, anyone can login to work on this, not just the executive director or emergency preparedness coordinator. Save Progress – click this button to save your work as you go. After you have worked on it for awhile and if you want to leave the screen to find an answer or work on something else, click this to save your work. However, if you try to leave for another page, you will be prompted to save your work. Do not close this window without saving along the way. Answers are not automatically saved. See next page for prompt to save. Show Glossary – click this for a glossary of terms used in the questionnaire

7. If you try to go to another page without clicking “save progress,” the system will prompt you to save the changes before leaving the page. Do not close the internet window without clicking “save progress,” or your work will not be saved.

8. Changing a response to a previously answered question: If you have already answered Question 18a, but now want to change your response, just click the “change” button, then click whatever response you now want, and then it will become green again. * Click new answer here Question becomes green and is complete