561 VA eBenefits Questionnaire 8-29-12

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Overview

Model Qsts
Current Custom Qsts
Current Custom Qsts (8-29-12)
Custom Qsts (3-20-12)

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Sheet 1: Model Qsts

Model Instance Name:
VA eBenefits
MID:	YdlIhdA4VstB05QNd8wgAA==
Date:
eBenefits
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 <b>accuracy of information</b> on this site.	17	What is your <b>overall satisfaction</b> with this site?	20	How likely are you to <b>return to this site</b>?
2	Please rate the <b>quality of information</b> on this site.	18	How well does this site <b>meet your expectations</b>?		Recommend (1=Not Very Likely, 10=Very Likely)
3	Please rate the <b>freshness of content</b> on this site.	19	How does this site <b>compare to your idea of an ideal website</b>?	21	How likely are you to <b>recommend this site to someone else</b>?
	Functionality (1=Poor, 10=Excellent, Don't Know)				Primary Resource (1=Not Very Likely, 10=Very Likely)
4	Please rate the <b>usefulness of the features provided</b> on this site.			22	How likely are you to use this site as your <b>primary resource for obtaining benefit information</b>?
5	Please rate the <b>convenience of the features</b> on this site.
6	Please rate the <b>variety of features</b> on this site.
	Look and Feel (1=Poor, 10=Excellent, Don't Know)
7	Please rate the <b>visual appeal</b> of this site.
8	Please rate the <b>balance of graphics and text</b> on this site.
9	Please rate the <b>readability of the pages</b> on this site.
	Navigation (1=Poor, 10=Excellent, Don't Know)
10	Please rate <b>how well the site is organized</b>.
11	Please rate the <b>options available for navigating</b> this site.
12	Please rate <b>how well the site layout helps you find what you are looking for</b>.
13	Please rate the <b>number of clicks to get where you want</b> on this site.
	Site Performance (1=Poor, 10=Excellent, Don't Know)
14	Please rate how <b>quickly pages load</b> on this site.
15	Please rate the <b>consistency of speed from page to page</b> on this site.
16	Please rate the <b>ability to load pages without getting error messages</b> on this site.

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Sheet 2: Current Custom Qsts

Model Instance Name:
VA eBenefits
MID: YdlIhdA4VstB05QNd8wgAA==			eBenefits Custom Questions
Date:
VA eBenefits 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	CQ Label
AKR4145		Which of the following best describes your role in visiting this site today? (Check all that apply)	Veteran	B	Checkbox, one-up vertical	Multi	Y	Skip Logic Group
(AKR4145G5)			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
AKR4146	A	Other Please Specify: Please tell us who you are.			Text area, no char limit	Single	N	Skip Logic Group
AKR4147	B	Please check the conflict(s) in which you served.	World War II		Checkbox, one-up vertical	Multi	N	Skip Logic Group
			Korean Conflict
			Vietnam Era
			Persian Gulf War
			Operation Enduring Freedom
			Operation Iraqi Freedom
			No conflict/war service
AKR4148		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+
AKR4149		Please select your gender:	Male		Radio button, one-up vertical	Single	N
			Female
AKR4150		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
CWS01722		Did you accomplish what you wanted to on the site?	Yes	A				Skip Logic Group
			I wasn’t planning to accomplish anything in particular
			No	B, C	Radio button, one-up vertical	Single	Y
ACQinh0011648	A	What primary task did you accomplish today?	I checked my claim status for compensation or pension		Radio button, one-up vertical	Single	Y	Skip Logic Group	Acc-Primary Task
			I checked my education claim status
			I registered for eBenefits
			I applied for a benefit
			I changed my profile or direct deposit information
			I looked for employment support
			Other (please specify)	A-1
ACQinh0011649	A-1	What other task did you primarily accomplish?			Text area, no char limit		N	Skip Logic Group	OE_Acc-Primary Task
ACQinh0011650	B	What primary task were you unable to accomplish today?	Register or Login	B-1	Radio button, one-up vertical	Single	Y	Skip Logic Group	Not Acc-Primary Task
			Check claim status for compensation or pension	B-2
			Check education claim status	B-3
			Apply for a benefit	B-4
			Manage my profile or direct deposit
			Find employment support
			Other, please specify	B-5
ACQinh0011651	B-5	What other task were you trying to accomplish?			Text area, no char limit		N	Skip Logic Group	OE_Not Acc-Other Task
ACQinh0011652	B-1	What difficulty did you have registering or logging into your account?	The site was down		Radio button, one-up vertical				Not Acc-Reg/Login
			My password expired
			I could not register for a Premium (Level 2) Account because I need to get approved in-person
			The information to register that I received in the mail did not work
			Other, please specify	B-1A
ACQinh0011671	B-1A	What is the other issue you had registering or logging into your account?			Text area, no char limit				OE_Not Acc-Reg/Login
ACQinh0011672	B-2	What difficulty did you have checking your compensation or pension claim status?	I found my status, but I don't think the data is correct		Radio button, one-up vertical				Not Acc-C/P Claim
			I could not get status because I do not have a Premium (Level 2) account
			I could login, but my page did not display	B-2B
			Other, please specify	B-2A
ACQinh0011675	B-2A	What is the other reason that you could not check your claim status?			Text area, no char limit				OE_Not Acc-C/P Claim
ACQhar0015092	B-2B	Have you been able to see a status view in previous visits?	No. I've never been able to get a status view.		Radio button, one-up vertical	Single	Y		Status View
			Sometimes I get a status view. Sometimes I don't.
			This is the first time I've had this problem.
ACQinh0011673	B-3	What difficulty did you have checking your education claim status?	I wanted payment status		Radio button, one-up vertical				Not Acc-Edu. Claim
			I needed certificate of eligibility
			Other, please specify	B-3A
ACQinh0011676	B-3A	What is the other reason you could not check your education claim status?			Text area, no char limit				OE_Not Acc-Edu. Claim
ACQinh0011674	B-4	What type of benefit did you try to apply for?			Text area, no char limit				OE_Not Acc-Ben Type
ACQOsl0002979	C	What will you do next?	Nothing, although I did not find/complete what I wanted		Radio button, one-up vertical	Single	Y	Skip Logic Group
			Call the eBenefits call center
			Return to the eBenefits site later and try again
			Send an email
			Other (please specify)	C-1
ACQOsl0002980	C-1	What else would you do next?			Text area, no char limit		Y	Skip Logic Group
ACQOsl0002983		Did you register for this site today?	Yes	A, B	Radio button, one-up vertical	Single	Y	OPS Group
			No, I have already registered	B
			No, I am not registered for this site.
ACQOsl0002984	A	Is there any additional information that would be helpful in the registration process?
ACQOsl0002985	B	Did you try to log in on this site today?	Yes	C	Radio button, one-up vertical	Single	Y	Skip Logic Group
			No
ACQOsl0002986	C	Were you able to log in successfully?	Yes, the first time I tried	D	Radio button, one-up vertical	Single	Y	Skip Logic Group
			Yes, after more than one try	D
			No, I was unable to log in	CC,D
ACQOsl0002987	CC	Why were you unable to log in?			Text area, no char limit		Y	Skip Logic Group
ACQOsl0002988	D	What, if anything, would you like improved about the log in process?			Text area, no char limit		N	Skip Logic Group
ACQDom0007579		Which of the following eBenefits features would you be likely to use on a mobile device? (Select all that apply.)	Access your eBenefits Message Center		Checkbox, one-up vertical	Multi	Y	Skip Logic Group
			Request documents from your Official Military Personnel file (such as your DD-214)
			Share your health records with private health care providers, the VA and the DoD
			Update your contact information for Compensation & Pension and Post-9/11 GI Bill Education benefits
			Browse and apply for state benefits
			Find an attorney, Claims Agent, or VSO to represent you for VA benefits claims
			View your Federal Individual Recovery Plan (FIRP)
			Other, please specify	A
			None, I would not access eBenefits features through a mobile device
ACQDom0007606	A	Other, please specify
CWS01724		If you could identify one improvement to this site, what improvement would you suggest?			Text area, no char limit	Single	N

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Sheet 3: Current Custom Qsts (8-29-12)

Model Instance Name:
VA eBenefits
MID: YdlIhdA4VstB05QNd8wgAA==			eBenefits Custom Questions
Date:
VA eBenefits 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	CQ Label
AKR4145		Which of the following best describes your role in visiting this site today? (Check all that apply)	Veteran	B	Checkbox, one-up vertical	Multi	Y	Skip Logic Group
(AKR4145G5)			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
AKR4146	A	Other Please Specify: Please tell us who you are.			Text area, no char limit	Single	N	Skip Logic Group
AKR4147	B	Please check the conflict(s) in which you served.	World War II		Checkbox, one-up vertical	Multi	N	Skip Logic Group
			Korean Conflict
			Vietnam Era
			Persian Gulf War
			Operation Enduring Freedom
			Operation Iraqi Freedom
			No conflict/war service
AKR4148		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+
AKR4149		Please select your gender:	Male		Radio button, one-up vertical	Single	N
			Female
AKR4150		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
CWS01722		Did you accomplish what you wanted to on the site?	Yes	A				Skip Logic Group
			I wasn’t planning to accomplish anything in particular
			No	B, C	Radio button, one-up vertical	Single	Y
ACQinh0011648	A	What primary task did you accomplish today?	I checked my claim status for compensation or pension		Radio button, one-up vertical	Single	Y	Skip Logic Group	Acc-Primary Task
			I checked my education claim status
			I registered for eBenefits
			I applied for a benefit
			I changed my profile or direct deposit information
			I looked for employment support
			Other (please specify)	A-1
ACQinh0011649	A-1	What other task did you primarily accomplish?			Text area, no char limit		N	Skip Logic Group	OE_Acc-Primary Task
ACQinh0011650	B	What primary task were you unable to accomplish today?	Register or Login	B-1	Radio button, one-up vertical	Single	Y	Skip Logic Group	Not Acc-Primary Task
			Check claim status for compensation or pension	B-2
			Check education claim status	B-3
			Apply for a benefit	B-4
			Manage my profile or direct deposit
			Find employment support
			Other, please specify	B-5
ACQinh0011651	B-5	What other task were you trying to accomplish?			Text area, no char limit		N	Skip Logic Group	OE_Not Acc-Other Task
ACQinh0011652	B-1	What difficulty did you have registering or logging into your account?	The site was down		Radio button, one-up vertical				Not Acc-Reg/Login
			My password expired
			I could not register for a Premium (Level 2) Account because I need to get approved in-person
			The information to register that I received in the mail did not work
			Other, please specify	B-1A
ACQinh0011671	B-1A	What is the other issue you had registering or logging into your account?			Text area, no char limit				OE_Not Acc-Reg/Login
ACQinh0011672	B-2	What difficulty did you have checking your compensation or pension claim status?	I found my status, but I don't think the data is correct		Radio button, one-up vertical				Not Acc-C/P Claim
			I could not get status because I do not have a Premium (Level 2) account
			I could login, but my page did not display	B-2B
			Other, please specify	B-2A
ACQinh0011675	B-2A	What is the other reason that you could not check your claim status?			Text area, no char limit				OE_Not Acc-C/P Claim
	B-2B	Have you been able to see a status view in previous visits?	No. I've never been able to get a status view.		Radio button, one-up vertical	Single	Y		Status View
			Sometimes I get a status view. Sometimes I don't.
			This is the first time I've had this problem.
ACQinh0011673	B-3	What difficulty did you have checking your education claim status?	I wanted payment status		Radio button, one-up vertical				Not Acc-Edu. Claim
			I needed certificate of eligibility
			Other, please specify	B-3A
ACQinh0011676	B-3A	What is the other reason you could not check your education claim status?			Text area, no char limit				OE_Not Acc-Edu. Claim
ACQinh0011674	B-4	What type of benefit did you try to apply for?			Text area, no char limit				OE_Not Acc-Ben Type
ACQOsl0002979	C	What will you do next?	Nothing, although I did not find/complete what I wanted		Radio button, one-up vertical	Single	Y	Skip Logic Group
			Call the eBenefits call center
			Return to the eBenefits site later and try again
			Send an email
			Other (please specify)	C-1
ACQOsl0002980	C-1	What else would you do next?			Text area, no char limit		Y	Skip Logic Group
ACQOsl0002981		How did you primarily look for information on the site today?	Chose a main menu item e.g. My eBenefits, Benefits Links etc.		Radio button, one-up vertical	Single	Y	OPS Group
			Clicked a link on the homepage
			Used the search box
			Narrowed choices by using the checkboxes on a Benefits Links page
			Other, please specify	A
ACQOsl0002982	A	How else did you look for information on the site?			Text area, no char limit		Y	OPS Group
ACQOsl0002983		Did you register for this site today?	Yes	A, B	Radio button, one-up vertical	Single	Y	OPS Group
			No, I have already registered	B
			No, I am not registered for this site.
ACQOsl0002984	A	Is there any additional information that would be helpful in the registration process?
ACQOsl0002985	B	Did you try to log in on this site today?	Yes	C	Radio button, one-up vertical	Single	Y	Skip Logic Group
			No
ACQOsl0002986	C	Were you able to log in successfully?	Yes, the first time I tried	D	Radio button, one-up vertical	Single	Y	Skip Logic Group
			Yes, after more than one try	D
			No, I was unable to log in	CC,D
ACQOsl0002987	CC	Why were you unable to log in?			Text area, no char limit		Y	Skip Logic Group
ACQOsl0002988	D	What, if anything, would you like improved about the log in process?			Text area, no char limit		N	Skip Logic Group
ACQDom0007579		Which of the following eBenefits features would you be likely to use on a mobile device? (Select all that apply.)	Access your eBenefits Message Center		Checkbox, one-up vertical	Multi	Y	Skip Logic Group
			Request documents from your Official Military Personnel file (such as your DD-214)
			Share your health records with private health care providers, the VA and the DoD
			Update your contact information for Compensation & Pension and Post-9/11 GI Bill Education benefits
			Browse and apply for state benefits
			Find an attorney, Claims Agent, or VSO to represent you for VA benefits claims
			View your Federal Individual Recovery Plan (FIRP)
			Other, please specify	A
			None, I would not access eBenefits features through a mobile device
ACQDom0007606	A	Other, please specify
CWS01724		If you could identify one improvement to this site, what improvement would you suggest?			Text area, no char limit	Single	N

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Sheet 4: Custom Qsts (3-20-12)

Model Instance Name:
VA eBenefits
MID: YdlIhdA4VstB05QNd8wgAA==			eBenefits Custom Questions
Date:
VA eBenefits 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	CQ Label
AKR4145		Which of the following best describes your role in visiting this site today? (Check all that apply)	Veteran	B	Checkbox, one-up vertical	Multi	Y	Skip Logic Group
(AKR4145G5)			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
AKR4146	A	Other Please Specify: Please tell us who you are.			Text area, no char limit	Single	N	Skip Logic Group
AKR4147	B	Please check the conflict(s) in which you served.	World War II		Checkbox, one-up vertical	Multi	N	Skip Logic Group
			Korean Conflict
			Vietnam Era
			Persian Gulf War
			Operation Enduring Freedom
			Operation Iraqi Freedom
			No conflict/war service
AKR4148		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+
AKR4149		Please select your gender:	Male		Radio button, one-up vertical	Single	N
			Female
AKR4150		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
AKR4151		What information were you primarily looking for today?	Financial		Radio button, one-up vertical	Single	Y	OPS Group
(AKR4151G1)			Education
			Employment
			Housing
			Health
			Burial
			Benefits
			Compensation
			Other, please specify	A
AKR4152	A	Other, please specify: What information were you primarily looking for today?			Text area, no char limit	Single	N	OPS Group
CWS01722		Did you accomplish what you wanted to on the site?	Yes	A				Skip Logic Group
			I wasn’t planning to accomplish anything in particular
			No, I wanted to:	B, C	Radio button, one-up vertical	Single	Y
CWS01723	A	No, I wanted to:			Text area, no char limit	Single	N	Skip Logic Group
	A	What primary task did you accomplish today?	I checked my claim status for compensation or pension		Radio button, one-up vertical	Single	Y	Skip Logic Group	Acc-Primary Task
			I checked my education claim status
			I registered for eBenefits
			I changed my profile or direct deposit information
			I looked for employment support
			Other (please specify)	A-1
	A-1	What other task did you primarily accomplish?			Text area, no char limit		N	Skip Logic Group	OE_Acc-Primary Task
	B	What primary task were you unable to accomplish today?	Register or Login	B-1	Radio button, one-up vertical	Single	Y	Skip Logic Group	Not Acc-Primary Task
			Check claim status for compensation or pension	B-2
			Check education claim status	B-3
			Apply for a benefit	B-4
			Manage my profile or direct deposit
			Find employment support
			Other, please specify	B-5
	B-1	What difficulty did you have registering or logging into your account?	The site was down		Radio button, one-up vertical				Not Acc-Reg/Login
			My password expired
			I could not register for a Premium (Level 2) Account because I need to get approved in-person
			The information to register that I received in the mail did not work
			Other, please specify	B-1A
	B-1A	What is the other issue you had registering or logging into your account?			Text area, no char limit				OE_Not Acc-Reg/Login
	B-2	What difficulty did you have checking your compensation or pension claim status?	I found my status, but I don't think the data is correct		Radio button, one-up vertical				Not Acc-C/P Claim
			I could not get status because I do not have a Premium (Level 2) account
			I could login, but my page did not display
			Other, please specify	B-2A
	B-2A	What is the other reason that you could not check your claim status?			Text area, no char limit				OE_Not Acc-C/P Claim
	B-3	What difficulty did you have checking your education claim status?	I wanted payment status		Radio button, one-up vertical				Not Acc-Edu. Claim
			I needed certificate of eligibility
			Other, please specify	B-3A
	B-3A	What is the other reason you could not check your education claim status?			Text area, no char limit				OE_Not Acc-Edu. Claim
	B-4	What type of benefit did you try to apply for?			Text area, no char limit				OE_Not Acc-Ben Type
	B-5	What other task were you trying to accomplish?			Text area, no char limit		N	Skip Logic Group	OE_Not Acc-Other Task
ACQOsl0002979	C	What will you do next?	Nothing, although I did not find/complete what I wanted		Radio button, one-up vertical	Single	Y	Skip Logic Group
			Call the eBenefits call center
			Return to the eBenefits site later and try again
			Send an email
			Other (please specify)	C-1
ACQOsl0002980	C-1	What else would you do next?			Text area, no char limit		Y	Skip Logic Group
ACQOsl0002981		How did you primarily look for information on the site today?	Chose a main menu item e.g. My eBenefits, Benefits Links etc.		Radio button, one-up vertical	Single	Y	OPS Group
			Clicked a link on the homepage
			Used the search box
			Narrowed choices by using the checkboxes on a Benefits Links page
			Other, please specify	A
ACQOsl0002982	A	How else did you look for information on the site?			Text area, no char limit		Y	OPS Group
ACQOsl0002983		Did you register for this site today?	Yes	A, B	Radio button, one-up vertical	Single	Y	OPS Group
			No, I have already registered	B
			No, I am not registered for this site.
ACQOsl0002984	A	Is there any additional information that would be helpful in the registration process?
ACQOsl0002985	B	Did you try to log in on this site today?	Yes	C	Radio button, one-up vertical	Single	Y	Skip Logic Group
			No
ACQOsl0002986	C	Were you able to log in successfully?	Yes, the first time I tried	D	Radio button, one-up vertical	Single	Y	Skip Logic Group
			Yes, after more than one try	D
			No, I was unable to log in	CC,D
ACQOsl0002987	CC	Why were you unable to log in?			Text area, no char limit		Y	Skip Logic Group
ACQOsl0002988	D	What, if anything, would you like improved about the log in process?			Text area, no char limit		N	Skip Logic Group
ACQDom0007579		Which of the following eBenefits features would you be likely to use on a mobile device? (Select all that apply.)	Access your eBenefits Message Center		Checkbox, one-up vertical	Multi	Y	Skip Logic Group
			Request documents from your Official Military Personnel file (such as your DD-214)
			Share your health records with private health care providers, the VA and the DoD
			Update your contact information for Compensation & Pension and Post-9/11 GI Bill Education benefits
			Browse and apply for state benefits
			Find an attorney, Claims Agent, or VSO to represent you for VA benefits claims
			View your Federal Individual Recovery Plan (FIRP)
			Other, please specify	A
			None, I would not access eBenefits features through a mobile device
ACQDom0007606	A	Other, please specify
CWS01724		If you could identify one improvement to this site, what improvement would you suggest?			Text area, no char limit	Single	N