Weights and Measures Division Customer Satisfaction Survey

Generic Request for Customer Service-Related Data Collections

0693-0031-WMDcustomer service eval-template 4-15-11.xlsx

Weights and Measures Division Customer Satisfaction Survey

OMB: 0693-0031

Document [xlsx]
Download: xlsx | pdf
Directions: Please indicate your evaluation of each item by circling the appropriate score and











include additional comments where applicable. Use the bottom of the second page if necessary.
























1. Overall Satisfaction




Don't know or Doesn't Apply Disagree > > > > Agree
This (product or service) exceeded my expectations:




0 1 2 3 4 5 6
I would recommend this (product or service) to others:




0 1 2 3 4 5 6













I liked the following thing best about the (product or service). Why?





































I liked the following thing least about the (product or service). Why?





































If I were to improve this (product or service) to make it more effective, I would:


















































2. Satisfaction: Accessibility




Don't know or Doesn't Apply Inadequate Poor Acceptable Good Very Good Outstanding
Availability and format of (product or service)




0 1 2 3 4 5 6
Quality of visuals/graphics or readability




0 1 2 3 4 5 6


























3. Satisfaction: Responsiveness




Don't know or Doesn't Apply Inadequate Poor Acceptable Good Very Good Outstanding
Professionalism and Courtesy of NIST staff




0 1 2 3 4 5 6
Timeliness of delivery of (product or service)




0 1 2 3 4 5 6
Ease of navigation/finding information




0 1 2 3 4 5 6







































Note: Please circle '0' for those that do not apply




Don't know or Doesn't Apply Disagree > > > > Agree
to this (product or service):




The technical content was relevant and applicable to my work:




0 1 2 3 4 5 6
The depth and quality of information was appropriate:




0 1 2 3 4 5 6
The (product or service) helped me to do my job




0 1 2 3 4 5 6
The (product or service) was sufficiently interactive




0 1 2 3 4 5 6


























4. Learning




No Knowledge Somewhat Familiar Familiar Very Familiar Very Familiar/Able to implement and share examples Expert
My understanding of this topic prior to using this (product or




0 1 2 3 4 5
service) was at this level:




I think my current understandng of this topic after using




0 1 2 3 4 5
the (product or service) is at this level:

















Please describe 3 things that you learned from this (product or service):































































5. Application











I learned and will apply the following items in the performance of my job































































May we contact you in 45 days to follow up on the application of this (product or service)?








Yes No
Contact Information:
























6. Needs Assessment











I need the following additional information or materials to improve performance of my responsiblities





































NOTE: This questionnaire contains collection of information requirements subject to the Paperwork Reduction Act (PRA). Notwithstanding any other provisions











of the law, no person is required to respond to, nor shall any person be subject to penalty for failure to comply with, a collection of information subject











to the requirements of the PRA, unless that collection of information displays a currently valid OMB Control Number.  The estimated response time for this











questionnaire is 5 minutes.  The response time includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,











and completing and reviewing the collection of information.  Send comments regarding this estimate or any other aspects of this collection of information,











including suggestions for reducing the length of this questionnaire, to the National Institute of Standards and Technology, Attn., Carol Hockert, [email protected],











301-975-4004. The OMB Control No. is 0693-0031, which expires on 2/29/2012.
























45 Day Follow-Up Questions
























1. If you have applied something, what did you apply and has there been an impact? Please describe.































































2. If you have not applied anything, but intended to do so, what were/are the barriers that have prevented your implementation?











Please explain.


































































































































































































































































NOTE: This questionnaire contains collection of information requirements subject to the Paperwork Reduction Act (PRA). Notwithstanding any other provisions











of the law, no person is required to respond to, nor shall any person be subject to penalty for failure to comply with, a collection of information subject











to the requirements of the PRA, unless that collection of information displays a currently valid OMB Control Number.  The estimated response time for this











questionnaire is 5 minutes.  The response time includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,











and completing and reviewing the collection of information.  Send comments regarding this estimate or any other aspects of this collection of information,











including suggestions for reducing the length of this questionnaire, to the National Institute of Standards and Technology, Attn., Carol Hockert, [email protected],











301-975-4004. The OMB Control No. is 0693-0031, which expires on 2/29/2012.











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