Peace Corps Medical Clearance Survey

Peace Corps Medical Clearance System

Thank you for participating in Peace Corps Office of Inspector General Medical Clearance survey. Peace Corps hopes that as a result of this survey, the Medical Screening Process is more efficient and transparent for applicants.

Your response to this survey is voluntary. Peace Corps will neither confer on you, nor deny you any benefit as a result of your response to this survey. This is a one-time written survey request. We estimate that it will take you 20 minutes to complete this survey. We appreciate your assistance in helping improve upon the service and efforts Peace Corps makes worldwide.

Peace Corps Medical Clearance System

	A small portion of respondents to this survey will be contacted to respond to a follow-up telephone interview. We estimate that the telephone interview will take 60 to 90 minutes; however, that timeframe may change dependent on the medical clearance issues each applicant wishes to discuss. Any personal information you provide in response to this survey will be kept confidential, consistent with the provisions of the Privacy Act, 5 USC 552a. Peace Corps will create a report summarizing all information collected. However, the report will not mention the names of respondents.

1		Name

2		Telephone

3

Applicant Type

	Applied but did not serve
	Invitee
	Trainee
	Peace Corps Volunteer
	Returned Peace Corps Volunteer

This survey addresses the stages of the Peace Corps application process shown below.

4

In the process of applying to the Peace Corps, was the application process (see diagram above) clear to you?

Not at all clear	Minimally clear	More or less clear	Very clear	Extremely clear	No opinion

5

Would posting a diagram of the application stages, like the one above, have been helpful to your understanding of the application process?

Not at all Helpful	Minimally Helpful	More or less Helpful	Very Helpful	Extremely Helpful	No opinion

The following questions address these stages of the application process:

6		During the application process, did you ask your recruiting officer medical-related questions?

7

Were you satisfied with the answers provided by the recruiting officer about your medical-related questions?

Not at all satisfied	Minimally satisfied	More or less satisfied	Very satisfied	Extremely satisfied	No opinion

8		Did your recruiting officer provide you with the Office of Medical Services (OMS) Nurse Line telephone number?

9		Were you able to speak to a nurse?

10

How many times did you call the Nurse Line before you were able to speak with a nurse?

	1 time
	2 times
	3 times
	4 times
	5 times
	More than 5 times

11

Were you satisfied with the nurse's responses to your medical or dental related questions?

Not at all Satisfied	Minimally Satisfied	More or Less Satisfied	Very Satisfied	Extremely Satisfied	No opinion

12		Were you made aware or provided the document, Medical Information for Applicants, which lists medical conditions that may delay or deter medical clearance?

13

Where did you find or from whom did you receive this document?

	Recruiting Officer
	Online
	Screening Assistant
	Screening Nurse
	Other, please specify

14

Did you find this document useful?

Not at all useful	Minimally useful	More or less useful	Very useful	Extremely useful	No opinion

15		If you found this document, "Not at all useful" or "Minimally Useful" please tell us why and how it could be improved.

The following questions address these stages of the application process:

16

From the time you received your Nomination Letter, approximately how many business days (Mon-Fri) did it take for you to receive your Medical Kit?

	1-3 days
	4-6 days
	7-9 days
	10-12 days
	13-15 days
	16-18 days
	More than 18 days

17

Were you made aware by your recruiting officer or online instructions, that if it took MORE than 14 days to receive your Medical Kit, you should call Office of Medical Services (OMS)?

	Yes- via recruiting officer
	Yes- via online
	No

	Medical Kit Instructions to the Applicant

18

Please rank the clarity of instructions provided to you on the following items:

1 Not at all clear	2 Minimally clear	3 More or less clear	4 Very clear	5 Extremely clear	6 Could not find	7 Did not read	8 No opinion
Medical Kit
Physical exam forms
Dental exam forms
Eye exam forms

19

Did the medical kit instructions give YOU a better understanding about why Peace Corps required all the medical and dental examinations?

	Yes
	No
	Somewhat

20		How could Peace Corps improve the Medical Kit guidance and instructions in terms of tone, format, clarity, etc.?

	Medical Kit Instructions to your Physician and Dentist

21

When you went to the doctor's office for your physical exam, who did you show the "Instructions to the Examining Physician" found in your Medical Kit? (Please check all that apply)

	Medical Clerk
	Attending Nurse
	Physician
	Other, please specify

22

Did your examining physician read the instructions provided by Peace Corps to better understand why Office of Medical Services (OMS) required all the medical tests and examinations listed in the Medical Kit?

	Yes
	No
	Partially read
	Did not read
	Don't know

23

When you went to the dentist's office for your dental exam, who did you show the "Instructions to the Examining Dentist" found in your Medical Kit? (Please check all that apply)

	Dental Clerk
	Dental Hygenist
	Dentist
	Other, please specify

24

Did your examining dentist read the instructions provided by Peace Corps to better understand why OMS required all the dental examinations listed in the Medical Kit?

	Yes
	No
	Partially read
	Did not read
	Don't know

25		What kind of response did you get from your physician or dentist regarding the instructions or information required in the Medical Kit?

	Medical Clearance Processing Time

26		In the process of completing your Medical Kit did you require replacement or additional forms?

27

After you received your Medical Kit, how long did it take before you were able to send it back to Office of Medical Services (OMS)?

	1 month or less
	1-3 months
	4-6 months
	7-9 months
	10-12 months
	More than 1 year
	More than 2 years
	Did not submit the medical kit

28

Please check all reasons that accurately explain why you did not submit your Medical Kit to Office of Medical Services (OMS):

	Medical costs
	Dental costs
	Medical Screening process took too much time
	Frustrated by lack of clarity in Medical Screening process
	Had condition listed on the Medical Information for Applicants document and I did not think Peace Corps would accept me
	Lack of Recruiting Officer Customer Service
	Lack of OMS Customer Service
	Returned to school
	Accepted a job offer
	Withdrew from entire application process
	Other, please specify

29		Did Office of Medical Services (OMS) request any additional medical information or tests not specified in your original Medical Kit?

30

How many times did Office of Medical Services (OMS) contact you to request missing or additional medical information/tests not specified in your original Medical Kit?

	1 time
	2 times
	3 times
	4 times
	5 times
	More than 5 times

31

What type(s) of additional information/testing were requested? (Please check all that apply; do not list medically confidential information)

	Test/Lab results
	Personal statements
	Doctor statements
	Specialist work
	Follow-up to previous medical conditions
	Other, please specify

32

In the process of completing your Medical Kit, was the meaning of the following terms clear to you:

1 Not at all clear	2 Minimally clear	3 More or less clear	4 Very clear	5 Extremely clear	6 Never heard the term before	7 No opinion
Medically qualified
Deferred
Medical accommodation/restrict
Medically not qualified

33

How long did it take you to Complete your Medical Kit, including any additional information requested by OMS?

	Less than 1 month
	1-3 months
	4-6 months
	7-9 months
	10-12 months
	More than 1 year
	More than 2 years
	Did not submit medical kit to OMS

34

From the time you sent in your Complete Medical Kit, how long did it take to hear back from OMS whether your were qualified, deferred, medically accommodated, or not qualified?

	Less than 1 month
	1-3 months
	4-6 months
	7-9 months
	10-12 months
	More than 1 year
	More than 2 years
	Did not submit medical kit to OMS

35

In total, how long did it take you to receive Medical Qualification? This refers to the period of time from receiving your Medical Kit to receiving your medical qualification letter. (This includes any appeals, medical accommodations, deferment, etc.)

	Less than 1 month
	1-3 months
	4-6 months
	7-9 months
	10-12 months
	More than 1 year
	More than 2 years
	Did not receive medical qualification

36		Did you appeal the Office of Medical Services' (OMS) decision regarding your medical suitability to serve as a Volunteer?

37

Were you made aware by a Screening Nurse of the appeals process and all possible outcomes that could result from your appeal?

	Yes
	No
	Somewhat

38

After submitting additional documentation, how long did it take for you to hear back from OMS regarding the outcome of your appeal?

	1 month or less
	1-3 months
	4-6 months
	7-9 months
	10-12 months
	More than 1 year
	Did not hear back from OMS

	Correspondence with the Office of Medical Services (OMS)

39

Throughout the medical screening process, did OMS lose or misplace any portion of your Medical Kit at any time? This includes lab results, personal statements, doctors' statements, medical forms, etc.

	Yes
	No
	Do not know

40

During the entire medical screening process, how many times did you contact your assigned Medical Screening Assistant to clarify instructions and requirements listed in the medical kit?

	Did not contact the Medical Screening Assistant
	1 time
	2 times
	3 times
	4 times
	5 times
	More than 5 times

41

How would you describe the customer service provided by your Medical Screening Assistant?

Not at all satisfactory	Minimally satisfactory	More or less satisfactory	Very satisfactory	Extremely satisfactory	No opinion

42

During the entire medical screening process, how many times did you contact the Dental Screening Assistant to clarify instructions and requirements listed in the medical kit?

	Did not contact the Dental Screening Assistant
	1 time
	2 times
	3 times
	4 times
	5 times
	More than 5 times

43

How would you describe the customer service provided by your Dental Screening Assistant?

Not at all satisfactory	Minimally satisfactory	More or less satisfactory	Very Satisfactory	Extremely satisfactory	No opinion

44

During the entire medical screening process, how many times did you contact a Screening Nurse to clarify instructions, requirements, or questions of a clinical nature?

	Did not contact the Screening Nurse
	1 time
	2 times
	3 times
	4 times
	5 times
	More than 5 times

45

How would you describe the customer service provided by your Screening Nurse?

Not at all satisfactory	Minimally satisfactory	More or less satisfactory	Very satisfactory	Extremely satisfactory	No opinion

46

How would you describe the customer service provided by any other member of the OMS Staff?

Not at all satisfactory	Minimally satisfactory	More or less satisfactory	Very satisfactory	Extremely satisfactory	No opinion

47		If you had a "Not at all satisfactory" or "Minimally satisfactory" customer service experience, please let us know. Please describe phone calls, e-mails, faxes, letters, specific individuals, conversations, etc. so we can identify the problem areas and make improvements to the process.

48		How could Peace Corps improve the medical screening process?

49		Were ALL costs in completing your Medical Kit fully covered by your health insurance?

50		Approximately what was your out of pocket cost?

51

Please rank whether the medical costs were a burden to your completing your Medical Kit right away.

Not at all	Minimally	More or less	Very	Extremely	No Opinion

52

Please rank whether the medical costs were a burden to becoming a Volunteer.

Not at all	Minimally	More or less	Very	Extremely	No Opinion

53

Please rank whether the dental costs were a burden to your completing your Medical Kit right away.

Not at all	Minimally	More or less	Very	Extremely	No Opinion

54

Please rank whether the dental costs were a burden to becoming a Volunteer.

Not at all	Minimally	More or less	Very	Extremely	No Opinion

55		Did you receive outside support (i.e. family members, church, etc.) with any of the Medical Kit costs?

56		How could Peace Corps improve the medical reimbursement process?

57		Did you complete the application process?

58

At what stage did you withdraw?

	Volunteer Application
	Health Status Review (HSR)
	Nomination
	Medical Kit (Before completion)
	Medical Kit (After completion)
	Invitation to serve as Volunteer

59		Why did you drop out at that stage?

60

Take a look at the list of categories below. Please check all categories that accurately explain why you withdrew from the application process:

	Returning to school
	Extended travel plans
	Personal/familial reasons
	Romantic involvement
	Work-related
	Military Issues
	Intelligence Activities
	Different Volunteer program found
	No longer interested in Peace Corps
	PC Program Cancelled
	Could not be assigned to desired country
	Medical Screening took too much time
	Medical condition would not permit service
	Burdensome medical costs
	Burdensome dental costs
	Other financial responsibilities
	Poor communication with Recruiting Officer
	Poor communication with Medical Screening
	Poor communication with Placement
	Other, please specify

61		What one thing would you do to make the Medical Clearance process better?

62		Are there any other comments you would like to make regarding Medical Screening?

	Demographics (Please answer these 5 demographic questions so we may determine whether the medical screening process is more burdensome to a particular type of applicant.)

63

Gender

	Male
	Female

64

Age

	20-29
	30-39
	40-49
	50-59
	60-69
	70-79
	80 and over

65

Ethnicity (please check all that apply)

	Black or African American
	American Indian or Alaska Native
	Native Hawaiian or other Pacific Islander
	White
	Hispanic
	Latino/Latina
	Asian
	Prefer not to respond

66

Highest Level of Education

	Did not complete High School
	High School Graduate/GED
	Technical School Graduate
	One or two years of College Completed
	A.A. Degree or Equivalent
	3rd year of College Completed
	College Graduate
	Graduate Study
	Graduate Degree
	Doctorate Degree
	Other

67

Marital Status

	Single (never married)
	Planning to Marry within One Year
	Married - Serving with Spouse
	Married - Serving without Spouse
	Widowed
	Divorced or Legally Separated
	Married while Serving as a Peace Corps Volunteer