FSR 254 VA eBenefits questionnaire

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Overview

Model Qsts
Custom Qsts
Types

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Sheet 1: Model Qsts

	E-Benefits Suggested Model Questions
E-Benefits
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Content (1=Poor, 10=Excellent, Don't Know)		Satisfaction (1=Poor, 10=Excellent)		Likelihood to Return (1=Not Very Likely, 10=Very Likely)
1	Please rate the accuracy of information on this site.	17	What is your overall satisfaction with this site?	20	How likely are you to return to this site?
2	Please rate the quality of information on this site.	18	How well does this site meet your expectations?		Recommend (1=Not Very Likely, 10=Very Likely)
3	Please rate the freshness of content on this site.	19	How does this site compare to your idea of an ideal website?	21	How likely are you to recommend this site to someone else?
	Functionality (1=Poor, 10=Excellent, Don't Know)				Primary Resource (1=Not Very Likely, 10=Very Likely)
4	Please rate the usefulness of the features provided on this site.			22	How likely are you to use this site as your primary resource for obtaining benefit information?
5	Please rate the convenience of the features on this site.
6	Please rate the variety of features on this site.
	Look and Feel (1=Poor, 10=Excellent, Don't Know)
7	Please rate the visual appeal of this site.
8	Please rate the balance of graphics and text on this site.
9	Please rate the readability of the pages on this site.
	Navigation (1=Poor, 10=Excellent, Don't Know)
10	Please rate how well the site is organized.
11	Please rate the options available for navigating this site.
12	Please rate how well the site layout helps you find what you are looking for.
13	Please rate the number of clicks to get where you want on this site.
	Site Performance (1=Poor, 10=Excellent, Don't Know)
14	Please rate how quickly pages load on this site.
15	Please rate the consistency of speed from page to page on this site.
16	Please rate the ability to load pages without getting error messages on this site.

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Sheet 2: Custom Qsts

			E-Benefits Custom Questions
CUSTOM QUESTION LIST
QID (Group ID)	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions
		Which of the following best describes your role in visiting this site today? (Check all that apply)	Veteran	B	Radio button, one-up vertical	Single	Y
			Active duty	B
			Wounded, injured, or ill service member	B
			Family of a service member or veteran
			Caregiver or delegate of a service member or veteran
			Health Care team member for a service member or veteran
			Other	A
	A	Other Please Specify: Please tell us who you are.			Text area, no char limit	Single	N
	B	Please check the conflict(s) in which you served.	World War II		Checkbox, one-up vertical	Multi	N
			Korean Conflict
			Vietnam Era
			Persian Gulf War
			Operation Enduring Freedom
			Operation Iraqi Freedom
			No conflict/war service
		Please select your age range.	17 or under		Radio button, one-up vertical	Single	N
			18-24
			25-34
			35-44
			45-54
			55-64
			65+
		Please select your gender:	Male		Radio button, one-up vertical	Single	N
			Female
		How frequently do you visit this site?	First time		Radio button, one-up vertical	Single	Y
			Daily
			About once a week
			About once a month
			About once or twice a year
			Less frequently than once a year
		What information were you primarily looking for today?	Financial		Radio button, one-up vertical	Single	Y
			Education
			Employment
			Housing
			Health
			Burial
			Benefits
			Compensation
			Other, please specify	A
	A	Other, please specify: What information were you primarily looking for today?			Text area, no char limit	Single	N

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Sheet 3: Types

Types		Instructions
Text field, <100 char		Randomize
Text area, no char limit		Shared
Drop down, select one		OPS Group
Radio button, one-up vertical		Matrix Group
Radio button, two-up vertical		Rank Group
Radio button, three-up vertical		Comparative Matrix Group
Radio button, scale, has don't know		Skip Logic Group
Radio button, scale, no don't know		Multiple Lists Group
Checkbox, one-up vertical		Partitioned
Checkbox, two-up vertical
Checkbox, three-up vertical