Five Customer Satisfaction Survey - Mail Surveys - Statistical

Field and Hearing Office

Give Social Security a Report Card… Using the rating scale shown below, please rate the service that you received on the day you visited the local Social Security office.
E = Excellent VG = Very Good G = Good F = Fair P = Poor VP = Very Poor
Based on your recent visit, mark [X] ONE rating for:	E	VG	G	F	P	VP
1. Office location	E	VG	G	F	P	VP
2. Office hours	E	VG	G	F	P	VP
3. Signs/instructions explaining how to check in when you got to the office	E	VG	G	F	P	VP
4. Usefulness of Social Security information in the waiting area (posters, pamphlets, TV presentations, etc.)	E	VG	G	F	P	VP
5. Office comfort (seating, temperature, etc.)	E	VG	G	F	P	VP
6. Office appearance (clean, pleasant, etc.)	E	VG	G	F	P	VP
7. Office privacy	E	VG	G	F	P	VP
8. Did you have an appointment? Mark [X] one.  Yes  (Go to 9.)  No  (Skip to 10.)
9. Convenience of your appointment	E	VG	G	F	P	VP
10. Waiting time to be served in the office	E	VG	G	F	P	VP
11. About how many minutes did you have to wait? Mark [X] only ONE.  Up to 10 minutes More than 10 and up to 30 minutes More than 30 and up to 60 minutes More than 60 minutes
12. Helpfulness of the staff	E	VG	G	F	P	VP
13. Courtesy of the staff	E	VG	G	F	P	VP
14. How well the staff knew their jobs	E	VG	G	F	P	VP
15. How clearly the staff explained things	E	VG	G	F	P	VP
16. Were you able to take care of your business in one visit to the office? Mark [X] one.  Yes  No
Mark [X] ONE rating.	E	VG	G	F	P	VP
17. Overall, how would you rate Social Security’s service during your recent office visit?	E	VG	G	F	P	VP
18. If you contact Social Security again, what are you most likely to do? Will you: Mark [X] only ONE.  Call Social Security’s National 800 number  Call a Social Security office  Visit a Social Security office  Use Social Security’s website  Other Explain:__________________________________________
To serve you better in the future, we would like to know how you prefer to do business with Social Security. 19. First, do you currently use the Internet? Mark [X] one  Yes  No  (Skip to 23.)
20. How do you access the Internet? Do you use: Mark [X] all that apply.  Laptop or personal computer  Wireless handheld device (Android, iPhone, Blackberry, etc.)
21. Have you ever visited Social Security’s Internet site? Mark [X] one  Yes  No
22. If you could have taken care of your recent business by using the Internet instead of visiting Social Security, how likely would you have been to do that? Would you have been: Mark [X] only ONE.  Very likely  Somewhat likely Not very likely, or Not at all likely to use the Internet instead of visiting
23. When you do business with Social Security, either in person, on the telephone, or online, do you need them to provide any special accommodations because of a medical condition? Mark [X] one  Yes  (Answer 24 and tell us what special accommodations you need in 25.)  No  (Skip to 25.)
24. How satisfied are you with how well Social Security meets your need for special accommodations? Are you: Mark [X] only ONE.  Very satisfied  Somewhat satisfied  Somewhat dissatisfied, or  Very dissatisfied
25. Please use this space to explain why you rated any item “F” (fair), “P” (poor), or “VP” (very poor) or to explain any of your other answers. ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________
Thank you for taking the time to rate Social Security! Please send us your “Report Card” in the enclosed postage-paid envelope as soon as possible.

Give Social Security a Report Card…
We would like to ask you a few questions about how you found out what you needed to do to apply for a Social Security card.
First, did you contact Social Security to find out how to apply for a new or replacement Social Security card before you visited the Social Security Card Center? Mark [X] one  Yes  No  (Skip to 4)
How did you contact Social Security for that information? Did you: Mark [X] all that apply. Call Social Security’s National 800 number Call a Social Security office Visit a Social Security office, or Visit Social Security’s website
How clear was the information you received about how to apply for a new or replacement Social Security card? Was it: Mark [X] one Very clear Somewhat clear Not very clear, or Not at all clear
Using the rating scale shown below, please rate the service that you received on the day you visited the Social Security Card Center.
E = Excellent VG = Very Good G = Good F = Fair P = Poor VP = Very Poor
Based on your recent visit, mark [X] ONE rating for:
4. Office location	E	VG	G	F	P	VP
5. Office hours	E	VG	G	F	P	VP
6. Signs/instructions explaining how to check in when you got to the office	E	VG	G	F	P	VP
7. Usefulness of Social Security information in the waiting area (posters, pamphlets, TV presentations, etc.)	E	VG	G	F	P	VP
8. Office comfort (seating, temperature, etc.)	E	VG	G	F	P	VP
9. Office appearance (clean, pleasant, etc.)	E	VG	G	F	P	VP
10. Office privacy	E	VG	G	F	P	VP
11. Waiting time to be served in the office	E	VG	G	F	P	VP
12. About how many minutes did you have to wait? Mark [X] only ONE.  Up to 10 minutes More than 10 and up to 30 minutes More than 30 and up to 60 minutes More than 60 minutes
Mark [X] ONE rating.	E	VG	G	F	P	VP
13. Helpfulness of the staff	E	VG	G	F	P	VP
14. Courtesy of the staff	E	VG	G	F	P	VP
15. How well the staff knew their jobs	E	VG	G	F	P	VP
16. How clearly the staff explained things	E	VG	G	F	P	VP
17. Were you able to take care of your business in one visit to the Social Security Card Center? Mark [X] one  Yes  No
18. Overall, how would you rate Social Security’s service during your recent visit?	E	VG	G	F	P	VP
19. To serve you better in the future, we would like to know how you prefer to do business with Social Security. First, what is your preferred language? Mark [X] only ONE.  English  Spanish  Other Explain:______________________________________________
Social Security has its own Internet site, www.socialsecurity.gov, that provides Social Security information and services online. We’d like to ask you a few questions about doing business on the Internet. 20. Do you currently use the Internet? Mark [X] one  Yes  No  (Skip to 23.)
21. How do you access the Internet? Do you use: Mark [X] all that apply.  Laptop or personal computer  Wireless handheld device (Android, iPhone, Blackberry, etc.)
22. Have you ever visited Social Security’s Internet site? Mark [X] one  Yes  No
23. If you could have taken care of your recent business by using the Internet instead of visiting Social Security, how likely would you have been to do that? Would you have been: Mark [X] only ONE.  Very likely  Somewhat likely  Not very likely, or  Not at all likely to use the Internet instead of visiting
24. When you do business with Social Security, either in person, on the telephone, or online, do you need them to provide any special accommodations because of a medical condition? Mark [X] one  Yes  (Answer 25 and tell us what special accommodations you need in 26.)  No  (Skip to 26.)
25. How satisfied are you with how well Social Security meets your need for special accommodations? Are you: Mark [X] only ONE.  Very satisfied  Somewhat satisfied  Somewhat dissatisfied, or  Very dissatisfied
26. Please use this space to explain why you rated any item “F” (fair), “P” (poor), or “VP” (very poor) or to explain any of your other answers. __________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________
Thank you for taking the time to rate Social Security! Please send us your “Report Card” in the enclosed postage-paid envelope as soon as possible.

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