VSD Comment Card Description

DOCUMENTATION FOR THE GENERIC CLEARANCE

OF CUSTOMER SATISFACTION SURVEYS

TITLE OF INFORMATION COLLECTION: Video Service Delivery Pilot Survey

DESCRIPTION OF ACTIVITY (give purpose of activity, provide specific information; i.e., date(s) of survey, number of focus groups, locations, etc.):

Description of Activity

Background

The Social Security Administration (SSA) is conducting a pilot called the Video Service Delivery (VSD) Pilot, in which the agency tests the feasibility of connecting SSA offices to other SSA offices and non-SSA community sites via video. We will place video equipment in SSA offices and convenient community locations, making it easier for the public to visit these sites. This pilot will allow SSA to test out a new service delivery mechanism that will reduce costs and traveling time for both the American public and SSA employees alike. This pilot consists of 40 SSA offices and 19 third party or community sites. Based on SSA internal projections, 1600 people are expected to benefit from this innovative service each month.

To get first-hand customer feedback on this video service, SSA plans to survey the public using comment cards. The comment cards will be provided to all individuals who utilize SSA’s new video service. The feedback obtained from these comment cards will allow SSA to make important decisions about expanding or curtailing the project and/or making reasonable changes to improve the quality of services provided by the video-conferencing technology.

SSA plans to use these public comment cards for at least a year; we may decide to extend the timeframe in the future.

Description of Actual Survey

Beginning almost immediately after receiving OMB approval, SSA will conduct the survey by placing the comment cards for completion at all video service sites. We will distribute comment cards in all 59 sites nationwide where the video service will be available. SSA will only choose as participants members of the public who use the new video service. Respondents will have the option of completing the comment card on-site and dropping it in a sealed box at the video-service location; alternatively, they can take the card home with them and later mail it to an SSA field office.

Please see the attached card for the specific customer service questions we plan to ask in the card.

Payment to Survey Participants

We will not compensate the public for completing these public comment cards.

Use of Survey Results

SSA employees will use these results to study the public’s satisfaction with the new video service. Based on the customer satisfaction feedback we receive, SSA will determine whether the public finds the video service delivery useful.

Burden Hour Computation (Number of responses (X) estimated response time

(/60) = annual burden hours):

Number of Responses: 1600/month (x 12 months of pilot) = 19,200

Estimated Response Time: 5 minutes

Annual Burden hours: 1600 hrs/year

Name of Contact Person: Faye I. Lipsky, 410-965-8783

VSD Comment Card GC (0960-0526)

April 2009

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