Form FSR 182 VA VHA FSR 182 VA VHA FSR 182 VA VHA

PROPOSED CUSTOM QUESTIONS FOR VA/VHA Custom questions complement the model questions and allow for additional data analysis
PROPOSED CUSTOM QUESTIONS FOR VA/VHA Custom questions complement the model questions and allow for additional data analysis	Answer Choices (limited to 50 characters)	Type drop-down menu check boxes radio buttons open-ended	Required Y/N	Select one or all that apply
How frequently do you visit this site?	First time	Drop-down menu	Y	select one
	More than once a day
	Daily
	About once a week
	About once a month
	Every 6 months
What best describes you?	Active duty	Drop-down menu	Y	select one
	Veteran
	Family member of a veteran
	Congress
	Veteran service organization
	News media
	General public
What information were you primarily looking for?	Healthcare	Drop-down menu	Y	select one
	Prescription
	VA benefits
	Medical center information
	Program information
	Life insurance
	Compensation and pension
	Educational programs
	Home loans
	Vocational rehabilitation and employment
	Burial services and benefits
	Presidential memorial certificate
	Jobs
	News
How were you trying to locate the information?	Browsing (following links in page)	Check boxes	Y	Multi-select
	Search engine
	Left navigation bar
	Top navigation bar
Did you find what you were looking for?	Yes	Drop-down menu	Y	select one
	No
What one improvement would you suggest for our site?	open-ended	text area	N	open-ended