Form FEMA Form 142-1-2 FEMA Form 142-1-2 Open Ended Questionaire

Chemical Stockpile Emergency Preparedness Program (CSEPP) Evaluation and Customer Satisfaction Survey

1660-0057, 142 1-2

Open Ended Questionaire

OMB: 1660-0057

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DEPARTMENT OF HOMELANDSECURITY
FEDERAL EMERGENCYMANAGEMENT AGENCY

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CSEPP OPEN ENDED QUESIIOIYNAIRE

O.M.B. Control No, 1660-0057
Expires April 30,2008

Pmawcuw EUROEN MUTOSURE H D ~ C E
Publlc reporting burden for thls form Is estimated to aw-e
.25 hours per response. The burden estlmate indudes the time for reviewing Instructions.
seardring exlsting data sources, gathering and maintaining the data needed, and completing and submitting this form. You are not requiredto mpond to
thls collection of Informadon unless It &plays a mlld OMB control number. Send comments regarding the accuracy of the burden estlrnate and any
~uggestlonrfor reducing the burden to: tnbrmarlon Ccdlectlons Management Depanment of HomelandSecurity, Federal Emergency ManagementAgency,
500 C Street, 5W,Winhingtoo, DC 2047L and P a p w o r k Reduca)on Project 06600057). Note: Do not send your completed fonn to thls address.

Intraductlan:
In an attempt to improve the quality of the pads and services that we provide to you,
FEMA CSEPP Headquartenr is preparing a customer satisfaction s w c y . We Mieve that
it is imporhm tbat this s w e y reflect those issues thaa are of most concern to you since
you are one ofour most important and influential CSEPP partners, Therefore, we wouM
Iike ylou to answer the following few questions regarding our perfmance. The answem
will form the basis of the actual satishtion questionnaire lhat you will receive later this
year md on an annual basis. Please be as candid and specific as possible so that we can
assure that your wncerns are properly refleefed in the h a 1 survey questionnaire. Thank
you very much for your timeWhat do you consider to be tha mort important goods and/or servkcs that
PEMA CSLPP provideo to you? Please list these goods and sarvkas in order

at Importance.

Whkh aspects of FEMA8ssupport of CSEPP are you satisfied with? Why?

Which aspects of FEHA's support bf CSEPP am you not satlrPled with? Why?

FEMA Fmm 142-1-2


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