VA Form 10-10059 Telephone Customer Service Experience Satisfaction Surve

OMB 2900-0770
Estimated Burden: 5 min.

Telephone Customer Service Experience Satisfaction Survey
THE PAPERWORK REDUCTION ACT OF 1995 requires us to notify you that this information collected is in accordance with the
clearance requirements of section 3507 of this Act. The public reporting burden for this collection of information is estimat ed to average 5
minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. No person will be penalized for failing to furnish this information if it
does not display a currently valid OMB control number. Your obligation to respond to this survey is voluntary and failure to furnish this
information will have no effect on any benefits you are entitled.

VISN 20 PACT Virtual Call Center Experience
Please rate your level of satisfaction with the following aspects of the Telephone Customer Service

Very
Satisfied

Satisfied

Neither
Satisfied nor
Dissatisfied

Dissatisfied

Very
Dissatisfied

1. How would you rate the
knowledge of the
representative?
2. How would you rate the
courteousness of the
representative?
3. How would you rate the
length of your wait time?

4. How long did you wait
before speaking to a live
person?

5. How many times have
you called about this
particular issue?

6. Was your issue resolved
during your call?

VA Form
APR 2013

10-10059

Under
1 minute

At least
1 minute

Under
2 minutes

More than
2 minutes

1 time

2 times

3 times

More than
3 times

Yes

No