Contact Survey

Contact Survey

FEMA Form 007-0-10

OMB No.: 1660-0036

Expires:

Public reporting burden for this survey is estimated to average 15 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting the survey. You are not required to respond to this collection of information unless it displays a valid OMB control number near the title of the electronic collection instrument, or for on-line applications, on the first screen viewed by the respondents. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (1660-0036) NOTE: Do not send your completed form to this address.

The following survey is voluntary.

Hello, I’m calling from FEMA, the Federal Emergency Management Agency. My name is ______. My ID # is: _______ May I please speak with ________________(applicant name)?

Are you the one who handled your FEMA application? If not the person who managed their case, ask: Is that person available? And may I ask their name?

If no: Thank you for your time and have a good day/evening. (Mark attempt)

If yes: We're looking for ways to improve the quality of our service and your opinion is very important to us.

Would you volunteer to take 5 - 8 minutes to answer some questions?

• If no: I understand, Thank you for your time. Have a good day/evening.

• If yes: Thank you. The following questions have been approved by the Office of Management and Budget under number 1660-0036. Please be assured your answers will not affect the outcome of your application for FEMA assistance.

If refused, document the Attempt Field as “Decline”. I understand. Thank you for your time.

First Call Resolution Training (This group of questions is for those who called the helpline multiple times.)
Question	Response Options
FCR1. After you registered, did you have a reason to call FEMA more than once about an unresolved issue? (DO NOT read list) (If “No” or “No, went on-line” or “Do not Remember”, go to next series.)	No No, went on-line Yes Do not remember
FCR1a. What was the main topic you called about? (DO NOT read list. Mark all that apply. Probe type of assistance when letter and documentation are selected.)	 Appeal process  Award Insufficient  Check Status  Clarification on FEMA call or letter  Correct Information on file  Inspection issues  Rental assistance  Other
FCR1a-1. How many times did you call about the same topic? (Do not read list)	2-3 times 4-5 times 6-10 times 11-15 times Over 15 Do not Remember
FCR1b. To what extent was your issue resolved to your satisfaction? Would you say it was…. (READ list) (If “Partially”, “Not at All” or “Still Pending”, go to Q.6c, otherwise skip to next series.)	Fully Partially Not at All Still Pending (DO NOT read) Don’t know
FCR1c. Why has your issue not been resolved? (DO NOT read list. Mark all that apply.)	 Award Insufficient Appeal in progress  Documentation not received / lost  Did not understand next steps  Have not heard from FEMA  Insurance not received or paperwork lost Future Options Other (Specify in comments box)

Automated Information System (IVR)
Question	Response Options
(Ask IVR1 when the information is not available electronically). CQIVR#1. Have you used FEMA’s automated information system to check the status of your case over the telephone? (Do not READ list) If No or Do not Remember, go to Next series of questions. If Yes go to IVR2	Yes No Do not Remember
CQIVR2. Were the instructions on the automated system easy to understand? (Do not READ list) If No, go to IVR2a. If Yes or Do Not Remember, go to IVR3.	Yes No Do not Remember
CQIVR2a. What made it difficult? (Do not READ list. Check all that apply)	Terminology was confusing Could not hear due to hearing issues Could not hear due to phone issues Could not hear due to recording not clear Information unclear Language or dialect issues Next steps unclear Other
IVR3. How would you rate the automated system in providing you the information you needed? Would you say it was… (READ list) If Not very helpful, or Not at all Helpful, ask IVR3a. Otherwise, go to IVR5.	Extremely Helpful Very Helpful Somewhat Helpful Not very Helpful Not at all Helpful (DO NOT read) Don’t know / No opinion

Automated Information System (IVR)	continued
Question	Response Options
IVR 3a. Please tell me specifically what was not helpful. (Do not Read the list. Check all that apply.)	Confusing terminology Could not navigate Could not skip through Did not understand the status Instructions unclear Instructions excessive Had to contact Helpline (record Yes in IVR4) Had to punch too many numbers Had to start over Needed additional information No way to repeat the needed instruction No way to go back to the beginning Not confident the status was accurate Poor sound quality Other (record specific reason)
For all responses: IVR4. After you used the system, did you need to speak to a FEMA Helpline Representative for additional information or clarification? If yes, go to IVR4a If No or Do not Remember, go to IVR5.	Yes No Tried but was not able to Reach the HL Do not Remember
IVR4a: At the beginning of the automated message, you were prompted to select specific numbers. After you made your menu selections, was your call transferred correctly so you could speak to a FEMA representative? If No, go to IVR4b If Yes, go to IVR4c	Yes No Do not Remember
IVR4b: What happened to your call?	Got the wrong selection Had to start over Could not skip through the prompts Had to wait for the Spanish script to end Spoke too fast Other

Automated Information System (IVR)	continued
Question	Response Options
IVR4c. What additional information did you need? (Do not Read the list. Check all that apply.)	To be sure the automated message was correct Status check Appeals process Next steps Assistance purpose Assistance timeline Assistance method of payment Correspondence inquiry To ask which of my documents had been received Documents inquiry Other (specify)
IVR5: Would you use the automated system again?	Yes No
IVR6. What suggestions do you have to improve the automated system? [If any, enter the suggestion]

HELPLINE - COMPONENTS
HL	For this series of questions, please use a scale of Excellent, good, satisfactory, below average, or poor. How would you rate the helpline process on: (READ scale only as needed)	Excellent	Good	Satisfactory	Below Average	Poor	Don’t Know/ No Opinion/Not Applicable
HLa	Reaching a representative by phone?
HLb	Helping you understand what additional information is needed?
HLc	Getting answers to your questions?
HLd	Resolving your issues?
HLe	Clarifying the assistance available to you?
HLf	Clearly describing the next steps in the process?
HLh	Letting you know how long it will take for your issue to be resolved?
HLi	Providing useful information to help your recovery?

Helpline - OVERALL
HLj	What would be your overall rating of FEMA’s Helpline process? (If Below Average or Poor, go to HLk, otherwise skip to Next Series)
			Excellent	Good	Satisfactory	Below Average	Poor	Don’t Know/ No Opinion

HLk	Why are you less than satisfied with the Helpline Process?
	(Clarify)

APPEAL PROCESS (ATTEMPT)
APL 1	How satisfied are you with the determination of your case? (If somewhat or extremely dissatisfied, go to APL1a, otherwise skip to next series of questions)	Extremely Satisfied Very Satisfied Satisfied Somewhat Dissatisfied Extremely Dissatisfied No Opinion/Don’t Know
APL 1a	Why were you dissatisfied?
APL 2	(This question is asked based on appeal flag, if they did not appeal, go to APL3.) (If they did appeal, ask: ) How did you hear about the appeal process? (Do not read) Skip to question APL6.	Helpline Letter from FEMA Friends/neighbors/family Don’t remember Other (Specify)
APL 3	Were you aware FEMA has an appeal process? If yes, go to APL4. If no, go to APL5.	Yes No Don’t Remember

APL 4	What was the main factor in your decision not to appeal?	Insufficient information on how to appeal Process too complicated Too much paperwork Paperwork lost in the disaster Not enough time Personal/emotional issues Don’t remember Other
APL5	What suggestions do you have to improve the appeal process?	Text

COMMUNICATIONS

Now, I would like you to consider the many ways you may have become aware of FEMA’s disaster assistance.

Question

Response Options

Com1. What were your main sources of FEMA disaster assistance information?

Source	Check
Television
Radio
Newspaper
Flyers/Signs
Schools/Local Organizations
Disaster Workers
State/Local Government
Social Media (Facebook,Twitter,etc.)
FEMA website/Internet
Voluntary Agencies
Insurance Company
Friends/Relatives/Neighbors
Other (Specify)

COMMUNICATIONS (Continued)

Question

Response Options

Com2. How would you rate each communication source mentioned

[insert sources] on providing the information you needed? Would you say it was…

(Select source checked and repeat if multiple sources.)

(READ scale only as needed)

		Excellent	Good	Satisfactory	Below Average	Poor	Don’t Know/ No Opinion
Source	Check
Television
Radio
Newspaper
Flyers/Signs
Schools/Local Organizations
Disaster Workers
State/Local Government
Social Media (Facebook, Twitter,etc)
FEMA website/Internet
Voluntary Agencies
Insurance Company
Friends/Relatives/Neighbors
Other (Specify)

Question	Response Options
Com3. When did you first hear that you could apply for FEMA disaster assistance?	Up to one week after the disaster declaration 2-3 weeks after the declaration 1-2 months after the declaration More than two months after the declaration Took a long time to be declared Other

COMMUNICATIONS (Continued)

Best Way To Contact

Response Options

Com4. What would be the best way for FEMA to provide general disaster assistance information to you after a disaster?

DO NOT READ (CHECK ONLY ONE)

Source	Best Way
Television
Radio
Newspaper
Flyers/Signs
Schools/Local Organizations
Disaster Workers
State/Local Government
Social Media (Facebook, Twitter,etc)
FEMA website/Internet
Voluntary Agencies
Insurance Company
Reverse 911 (Auto Dialer)
Email/Text Message
Friends/Relatives/Neighbors
Other (Specify)

Com4a. What suggestions do you have to improve FEMA’s communication?_________________________________________

INTERNET INQUIRY / UPDATE (Skip if internet inquiry tracked in NEMIS event log)
These next questions are about using the Internet to check the status of your case.
IIU1. Did you try to use the fema.gov site with a mobile device?	No (Go to IIU1a) Yes (Go to IIU2) (DO NOT read) Don’t remember (Skip to next series)
IIU1a What were your reasons for not using a mobile device to check on your case? (Do not read list) (Go to next series)	Don’t have a mobile device Don’t have mobile internet access Device damaged Limited computer skills Security concerns FEMA.gov was not accessible Wanted to talk to FEMA Didn’t know about the mobile on-line service Utilities were out (battery charge issue) No cell service Other (specify)
IIU2 How would you rate your satisfaction using a mobile device to check the status of your case? (If Somewhat or Extremely Dissatisfied go to IIU2a, otherwise go to next series)	Extremely Satisfied Very Satisfied Satisfied Somewhat Dissatisfied Extremely Dissatisfied (DO NOT read) Don‘t know / No opinion
IIU2a. In what way were you dissatisfied. (Do not read list)	Could not find the information needed Could not update my information (DO NOT read) Don’t remember (Skip to next series)

SUGGESTIONS TO IMPROVE
Question		Response Options
Suggestion. FEMA is interested in getting your opinion on what we could do to improve our service. What other suggestions would you like to pass on to improve FEMA disaster assistance process that you haven’t already shared? (Clarify all vague responses. Probe once with “WHAT OTHER SUGGESTIONS?”)		Open-ended Question Type response in designated area. ________________________________________________________________________________________________________________________________________________________

CALLBACK QUESTION
Question		Response Options
Call back: Your opinion is very valuable to us, may we call you at a later date to ask you some additional questions?		Yes No

CLOSING
Yes (If “yes”) Thank you for your time. Have a good day/evening.
No (If “no”) I understand. Thank you for your time. Have a good day/evening.

FEMA Form 007-0-10 14