Questionnaire Production Guidelines_Template

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Model Instance Name:
IRS ACH
MID:
Date: 11/01/2013

Welcome and Thank You Text
Directions:
This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom.
This is a good place to mention the site/company/agency name so the visitor knows whom they are
taking the survey for. Feel free to modify the standard Welcome and Thank you text shown in the boxes
below. Please read comments before using any of the text.

Examples
Welcome Text Example

Welcome Text
Thank you for visiting IRS Direct Pay. You've been randomly chosen to take part in a brief survey about this
service.
Please take a few minutes to share your opinions which will help us create the best experience possible for you.

Thank You Text Example
DEFAULT Thank You Text
“Thank you for taking our survey - and for helping us serve you better. We appreciate your input!”

ALTERNATE WEB Thank You Text

'web site' has been corrected to now read
'website' in the text to the left

Thank you for taking our survey - and for helping us serve you better.
Please note you will not receive a response from us based on your survey comments. If you would like us to
contact you about your feedback, please visit the Contact Us section of our website.

ForeSee Results - Confidential and Proprietary

Model Instance Name:
IRS ACH
MID:
Partitioned (Y/N)? Y
Date: 11/01/2013
IRS ACH
Model questions utilize the ACSI methodology to determine scores and impacts
ELEMENTS (drivers of satisfaction)
Site Information (1=Poor, 10=Excellent, Don't Know)
1 Please rate the thoroughness of information provided on

IRS Direct Pay.
2 Please rate how understandable information is on IRS Direct

Pay.
3 Please rate how well IRS Direct Pay information provides

answers to your questions.
Site Performance (1=Poor, 10=Excellent, Don't Know)
4 Please rate how quickly pages load on IRS Direct Pay.
5 Please rate the consistency of speed from page to page on
IRS Direct Pay.
6 Please rate the ability to load pages without getting error
messages on IRS Direct Pay.
Navigation (1=Poor, 10=Excellent, Don't Know)
7 Please rate how well IRS Direct Pay is organized.
8 Please rate the options available for navigating IRS Direct
Pay.
9 Please rate how well IRS Direct Pay layout helps you find
what you are looking for.
Look and Feel (1=Poor, 10=Excellent, Don't Know)
10 Please rate the visual appeal of IRS Direct Pay.
11 Please rate the balance of graphics and text on IRS Direct
Pay.
12 Please rate the readability of the pages on IRS Direct Pay.
Tasks/ Transactions (1=Poor, 10=Excellent, Don't Know)
13 Please rate the simplicity of the process for completing
task(s) on IRS Direct Pay.
14 Please rate the clarity of instructions for completing task(s)
on IRS Direct Pay.
15 Please rate the verification of task completion on IRS Direct
Pay.

CUSTOMER SATISFACTION

FUTURE BEHAVIORS

Satisfaction
16 What is your overall satisfaction with IRS Direct Pay?

Recommend (1=Very Unlikely, 10=Very Likely)
19 How likely are you to recommend IRS Direct Pay to someone

(1=Very Dissatisfied, 10=Very Satisfied)

else?

17 How well does IRS Direct Pay meet your expectations?

Return (1=Very Unlikely, 10=Very Likely)

(1=Falls Short, 10=Exceeds)
18 How does IRS Direct Pay compare to your idea of an ideal

pay service? (1=Not Very Close, 10=Very Close)

20

How likely are you to return to IRS Direct Pay in the future?
Use Service (1=Very Unlikely, 10=Very Likely)

21 How likely are you to use IRS Direct Pay again in the future?

ForeSee Results - Confidential and Proprietary

Model Instance Name:
IRS ACH
MID:
Date: 11/01/2013

red & strike-through: DELETE
underlined & italicized: RE-ORDER
pink: ADDITION
blue + -->: REWORDING

IRS ACH CUSTOM QUESTION LIST

QID

Skip
Logic
Label

Answer Choices
(limited to 50 characters)
16-21
22-35
36-50
51-65
Above 66
Prefer not to respond
What is your gender?
Male
Female
Prefer not to respond
What is your income level?
Under $30,000
$30,000-$50,000
$50,0000-$80,000
$80,000-$120,000
Above $120,000
Prefer not to respond
Is this your first time using IRS Direct Pay?
Yes
No
What features or benefits prompted you to use IRS Direct Pay?
Online payment option
No fees
No registration
All of the above
None of the above
Other
Did you previously use an alternative method to submit payments to Yes
the IRS?
No
Which of the following methods did you use?
Paper process
Online Credit Card Payment
EFTPS
Other
Would you use IRS Direct Pay in the future?
Yes
Not sure
No
How easy it was to complete your payment transaction today?
Very easy
Somewhat easy
Somewhat difficult
Very difficult
No opinion
Question Text

Skip to

What is your age?

A

A

A

Please tell us what prevented you from completing your transaction
today.

Required
Y/N
N

Drop down, select one

S

N

Gender

Drop down, select one

S

N

Income

Radio button, one-up vertical

S

Y

First time

Checkbox, one-up vertical

M

Y

Features

Radio button, one-up vertical

S

Y

Alternate method

Checkbox, one-up vertical

M

Y

Methods

Radio button, one-up vertical

S

Y

Use again

Radio button, one-up vertical

S

Y

Ease of transaction

N

Incomplete
transaction
Additional services

Text area, no char limit
Checkbox, one-up vertical

View your outstanding payment balance due to the IRS
Other, please specify
Please tell us what other additional service would you like to have
within IRS Direct Pay.
How likely are you to call customer service as a result of your visit
today?

Single or
Multi
S

Special Instructions

CQ Label
Age

A
A

From the following list, please tell us what additional services would Save your bank account information for easier future payments
you like to have within IRS Direct Pay?
Look up your payment history

A

Type (select from list)
Drop down, select one

M

Y

A
Text area, no char limit

1=Very Unlikely

Radio button, scale, has don't know

S

N

Other service

Y

Customer service

N

Improvement

2
3
4
5
6
7
8
9
10=Very Likely
Don’t know

If you could improve one thing within IRS Direct Pay service, please
tell us what that would be?

Text area, no char limit

ForeSee Results - Confidential and Proprietary