Model Instance Name: | |||||
DOD TRICARE | |||||
MID: | EkBkYwMF5pUhJZssIpM89w== | ||||
Date: | 2004 | ||||
DOD TRICARE MODEL QUESTION LIST | |||||
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 accuracy of information on this site. | 21 | What is your overall satisfaction with this site? | 24 | How likely are you to return to this site? |
2 | Please rate the quality of information on this site. | 22 | How well does this site meet your expectations? | Recommend (1=Not Very Likely, 10=Very Likely) | |
3 | Please rate the freshness of content on this site. | 23 | How does this site compare to your idea of an ideal website? | 25 | How likely are you to recommend this site to someone else? |
Functionality (1=Poor, 10=Excellent, Don't Know) | Primary Resources (1=Not Very Likely, 10=Very Likely) | ||||
4 | Please rate the usefulness of the services provided on this site. | 26 | How likely are you to use this site as your primary resource for obtaining information from this organization? | ||
5 | Please rate the convenience of the services on this site. | ||||
6 | Please rate the ability to accomplish what you wanted to on this site. | ||||
Look and Feel (1=Poor, 10=Excellent, Don't Know) | |||||
7 | Please rate the ease of reading this site. | ||||
8 | Please rate the clarity of site organization. | ||||
9 | Please rate the clean layout of this site. | ||||
Navigation (1=Poor, 10=Excellent, Don't Know) | |||||
10 | Please rate the degree to which the number of steps it took to get where you want is acceptable. | ||||
11 | Please rate the ability to find the information you want on this site. | ||||
12 | Please rate the clarity of site map/directory. | ||||
13 | Please rate the ease of navigation on this site. | ||||
Search (1=Poor, 10=Excellent, Don't Know) | |||||
14 | Please rate the usefulness of search results on this site. | ||||
15 | Please rate how this site provides comprehensive search results. | ||||
16 | Please rate the organization of search results for this site. | ||||
17 | Please rate how the search feature helps you to narrow the results to find the information you want. | ||||
Site Performance (1=Poor, 10=Excellent, Don't Know) | |||||
18 | Please rate the speed of loading the page on this site. | ||||
19 | Please rate the consistency of speed on this site. | ||||
20 | Please rate the reliability of site performance on this site. |
Model Instance Name: | |||||||||
DOD TRICARE | underlined & italicized: RE-ORDER | ||||||||
MID: EkBkYwMF5pUhJZssIpM89w== | pink: ADDITION | ||||||||
Date: | 7/16/2012 | blue + -->: REWORDING | |||||||
DOD TRICARE CUSTOM QUESTION LIST | |||||||||
CQID | 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 | |
5923 | How frequently do you visit our site? | First time | Drop down, select one | Single | Y | ||||
Every 6 months or less | |||||||||
About once a month | |||||||||
About once a week | |||||||||
Daily | |||||||||
More than once a day | |||||||||
MMM00067 | Which of the following best describes your role in visiting our site today? | TRICARE beneficiary | E, F, G, 2A | Radio button, one-up vertical | Single | Y | |||
Family, friend or caregiver of TRICARE beneficiary | |||||||||
Future TRICARE beneficiary | |||||||||
TRICARE Network Provider or Provider Staff | |||||||||
TRICARE Non-Network Provider or Provider Staff | |||||||||
Prospective TRICARE Provider or Provider Staff | |||||||||
Military Treatment Facility Clinical Staff | |||||||||
TRICARE Beneficiary Advisors and Customer Service Staff | |||||||||
All other Military Health System/TRICARE staff (Including government and supporting contractors) | |||||||||
Media/Researcher | |||||||||
Other | |||||||||
5929 | E | Which best describes your status? | Active Duty Service Member | Radio button, one-up vertical | Single | N | |||
Family of Active Duty Service Member | |||||||||
Family of Deceased Active Duty Service Member | |||||||||
National Guard or Reserve Member (Activated) | |||||||||
Family of National Guard or Reserve Member (Activated) | |||||||||
National Guard or Reserve member (Non-Activated) | |||||||||
Family of National Guard or Reserve Member (Non-Activated) | |||||||||
Retired Service Member | |||||||||
Family of Retired Service Member | |||||||||
Family of Deceased Retired Service Member | |||||||||
Other Beneficiary | |||||||||
Not Applicable | |||||||||
MMM00068 | F | Which of the following best describes your TRICARE enrollment option? | Sponsor is active duty (no premium paid) | Radio button, one-up vertical | |||||
Sponsor is active duty and family member has disenrolled from Prime to use TRICARE Standard | Single | N | |||||||
Sponsor is retired and we pay either $260/individual or $520/family per year | |||||||||
Sponsor is retired and we pay the Medicare Part B premium; TRICARE for Life | |||||||||
Sponsor is retired (and we do NOT pay either a TRICARE or Medicare Part B premium; TRICARE Standard) | |||||||||
Not applicable | |||||||||
MMM00389 | 2A | Did you create a profile based on your beneficiary category, where you live and which TRICARE plan you’re in? | Yes | Radio button, one-up vertical | Single | ||||
No | |||||||||
MMM00061 | Which of the following best describes your main reason for visiting our Web site today? | Find out what’s covered | Radio button, one-up vertical | Single | Y | Randomize | |||
Look up costs | |||||||||
Find a military or civilian doctor | |||||||||
Make an appointment | |||||||||
Referral | |||||||||
Find contact information | |||||||||
Find claims information | |||||||||
Find enrollment information | |||||||||
Pharmacy | |||||||||
Check eligibility | |||||||||
Update personal information | |||||||||
Learn about the plans / options | |||||||||
Look for health/wellness information | |||||||||
Other (please explain) | A | ||||||||
MMM00062 | A | Other | Text field, <100 char | ||||||
AED05079 | Did you find what you were looking for on our Web site today? | Yes | |||||||
No | K, L | ||||||||
MMM00065 | K | If you did not find what you were looking for, what will you do now? | Try a different Web site | Radio button, one-up vertical | Single | N | |||
Call a toll-free number | |||||||||
Read a TRICARE brochure or handbook | |||||||||
Visit a TRICARE Service Center | |||||||||
Visit a Military Treatment Facility | |||||||||
Other | C | ||||||||
Not applicable | |||||||||
MMM00066 | C | Please explain what you will do now. | Text field, <100 char | ||||||
5926 | L | If you did not find what you were looking for on our Web site, what was it? | Text area, no char limit | N | |||||
51492 | What method are you primarily using to locate the information you are looking for? | Search Bar | 2A | Drop down, select one | Single | Y | SKIP LOGIC GROUP | ||
Clicking tabs or links | |||||||||
Site Map | |||||||||
Other | 1A | ||||||||
ACQwil0013622 | 1A | What other method are you using? | Text area, no char limit | ||||||
ACQinh0014241 | 2A | Please describe your experience with the site's search feature. | Very helpful | Radio button, one-up vertical | Single | No | |||
Somewhat helpful | 3A, 3B | ||||||||
Not at all helpful | 3A, 3B | ||||||||
ACQOsl0002177 | 3A, 3B | What key word(s) did you use to search? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
ACQinh0014242 | 3A, 3B | What information were you searching for on the site? | Text area, no char limit | ||||||
MMM00056 | How did you get to our Web site today? | Referred by TRICARE brochure or handbook | Drop down, select one | Single | Y | ||||
Referred by TRICARE customer service representative | |||||||||
Typed in the address | |||||||||
Search engine (such as Google or Yahoo) | |||||||||
Bookmarks or Favorites | |||||||||
Link from another Web site | |||||||||
Other |
Model Instance Name: | |||||||||
DOD TRICARE | underlined & italicized: RE-ORDER | ||||||||
MID: EkBkYwMF5pUhJZssIpM89w== | pink: ADDITION | ||||||||
Date: | 7/16/2012 | blue + -->: REWORDING | |||||||
DOD TRICARE CUSTOM QUESTION LIST | |||||||||
CQID | 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 | |
5923 | How frequently do you visit our site? | First time | Drop down, select one | Single | Y | ||||
Every 6 months or less | |||||||||
About once a month | |||||||||
About once a week | |||||||||
Daily | |||||||||
More than once a day | |||||||||
MMM00067 | Which of the following best describes your role in visiting our site today? | TRICARE beneficiary | E, F, G, 2A | Radio button, one-up vertical | Single | Y | |||
Family, friend or caregiver of TRICARE beneficiary | |||||||||
Future TRICARE beneficiary | |||||||||
TRICARE Network Provider or Provider Staff | |||||||||
TRICARE Non-Network Provider or Provider Staff | |||||||||
Prospective TRICARE Provider or Provider Staff | |||||||||
Military Treatment Facility Clinical Staff | |||||||||
TRICARE Beneficiary Advisors and Customer Service Staff | |||||||||
All other Military Health System/TRICARE staff (Including government and supporting contractors) | |||||||||
Media/Researcher | |||||||||
Other | |||||||||
5929 | E | For TRICARE beneficiaries only- Which best describes your status? | Active Duty Service Member | Radio button, one-up vertical | Single | N | |||
Family of Active Duty Service Member | |||||||||
Family of Deceased Active Duty Service Member | |||||||||
National Guard or Reserve Member (Activated) | |||||||||
Family of National Guard or Reserve Member (Activated) | |||||||||
National Guard or Reserve member (Non-Activated) | |||||||||
Family of National Guard or Reserve Member (Non-Activated) | |||||||||
Retired Service Member | |||||||||
Family of Retired Service Member | |||||||||
Family of Deceased Retired Service Member | |||||||||
Other Beneficiary | |||||||||
Not Applicable | |||||||||
MMM00068 | F | For TRICARE beneficiaries only: Which of the following best describes your TRICARE enrollment option? | Sponsor is active duty (no premium paid) | Radio button, one-up vertical | |||||
Sponsor is active duty and family member has disenrolled from Prime to use TRICARE Standard | Single | N | |||||||
Sponsor is retired and we pay either $260/individual or $520/family per year | |||||||||
Sponsor is retired and we pay the Medicare Part B premium; TRICARE for Life | |||||||||
Sponsor is retired (and we do NOT pay either a TRICARE or Medicare Part B premium; TRICARE Standard) | |||||||||
Not applicable | |||||||||
MMM00389 | 2A | Did you create a profile based on your beneficiary category, where you live and which TRICARE plan you’re in? | Yes | Radio button, one-up vertical | Single | ||||
No | |||||||||
MMM00061 | Which of the following best describes your main reason for visiting our Web site today? | Find out what’s covered | Radio button, one-up vertical | Single | Y | Randomize | |||
Look up costs | |||||||||
Find a military or civilian doctor | |||||||||
Make an appointment | |||||||||
Referral | |||||||||
Find contact information | |||||||||
Find claims information | |||||||||
Find enrollment information | |||||||||
Pharmacy | |||||||||
Check eligibility | |||||||||
Update personal information | |||||||||
Learn about the plans / options | |||||||||
Look for health/wellness information | |||||||||
Other (please explain) | A | ||||||||
MMM00062 | A | Other | Text field, <100 char | ||||||
AED05079 | Did you find what you were looking for on our Web site today? | Yes | |||||||
No | K, L | ||||||||
MMM00065 | K | If you did not find what you were looking for, what will you do now? | Try a different Web site | Radio button, one-up vertical | Single | N | |||
Call a toll-free number | |||||||||
Read a TRICARE brochure or handbook | |||||||||
Visit a TRICARE Service Center | |||||||||
Visit a Military Treatment Facility | |||||||||
Other | C | ||||||||
Not applicable | |||||||||
MMM00066 | C | Please explain what you will do now. | Text field, <100 char | ||||||
5926 | L | If you did not find what you were looking for on our Web site, what was it? | Text area, no char limit | N | |||||
51492 | What method are you primarily using to locate the information you are looking for? | Search Bar | H, 2A | Drop down, select one | Single | Y | SKIP LOGIC GROUP | ||
Clicking tabs or links | |||||||||
Site Map | |||||||||
Other | 1A | ||||||||
ACQwil0013622 | 1A | What other method are you using? | Text area, no char limit | ||||||
NEW | 2A | Please describe your experience with the site's search feature. | Very helpful | Radio button, one-up vertical | Single | No | |||
Somewhat helpful | 3A, 3B | ||||||||
Not at all helpful | 3A, 3B | ||||||||
ACQOsl0002177 | H, 3A, 3B | What key word(s) did you use to search? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
NEW | 3A, 3B | What information were you searching for on the site? | Text area, no char limit | ||||||
MMM00056 | How did you get to our Web site today? | Referred by TRICARE brochure or handbook | Drop down, select one | Single | Y | ||||
Referred by TRICARE customer service representative | |||||||||
Typed in the address | |||||||||
Search engine (such as Google or Yahoo) | |||||||||
Bookmarks or Favorites | |||||||||
Link from another Web site | |||||||||
Other | |||||||||
Model Instance Name: | |||||||||
DOD TRICARE | underlined & italicized: RE-ORDER | ||||||||
MID: EkBkYwMF5pUhJZssIpM89w== | pink: ADDITION | ||||||||
Date: | 6/18/2012 | blue + -->: REWORDING | |||||||
DOD TRICARE CUSTOM QUESTION LIST | |||||||||
CQID | 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 | |
5923 | How frequently do you visit our site? | First time | Drop down, select one | Single | Y | ||||
Every 6 months or less | |||||||||
About once a month | |||||||||
About once a week | |||||||||
Daily | |||||||||
More than once a day | |||||||||
MMM00067 | Which of the following best describes your role in visiting our site today? | TRICARE beneficiary | E, F, G | Radio button, one-up vertical | Single | Y | |||
Family, friend or caregiver of TRICARE beneficiary | |||||||||
Future TRICARE beneficiary | |||||||||
TRICARE Network Provider or Provider Staff | |||||||||
TRICARE Non-Network Provider or Provider Staff | |||||||||
Prospective TRICARE Provider or Provider Staff | |||||||||
Military Treatment Facility Clinical Staff | |||||||||
TRICARE Beneficiary Advisors and Customer Service Staff | |||||||||
All other Military Health System/TRICARE staff (Including government and supporting contractors) | |||||||||
Media/Researcher | |||||||||
Other | |||||||||
5929 | E | For TRICARE beneficiaries only- which best describes your status? | Active Duty Service Member | Radio button, one-up vertical | Single | N | |||
Family of Active Duty Service Member | |||||||||
Family of Deceased Active Duty Service Member | |||||||||
National Guard or Reserve Member (Activated) | |||||||||
Family of National Guard or Reserve Member (Activated) | |||||||||
National Guard or Reserve member (Non-Activated) | |||||||||
Family of National Guard or Reserve Member (Non-Activated) | |||||||||
Retired Service Member | |||||||||
Family of Retired Service Member | |||||||||
Family of Deceased Retired Service Member | |||||||||
Other Beneficiary | |||||||||
Not Applicable | |||||||||
MMM00068 | F | For TRICARE beneficiaries only: which of the following best describes your TRICARE enrollment option? | Sponsor is active duty (no premium paid) | Radio button, one-up vertical | |||||
Sponsor is active duty and family member has disenrolled from Prime to use TRICARE Standard | Single | N | |||||||
Sponsor is retired and we pay either $260/individual or $520/family per year | |||||||||
Sponsor is retired and we pay the Medicare Part B premium; TRICARE for Life | |||||||||
Sponsor is retired (and we do NOT pay either a TRICARE or Medicare Part B premium; TRICARE Standard) | |||||||||
Not applicable | |||||||||
5928 | G | For TRICARE beneficiaries only- do you receive most of your care from: | A military clinic or hospital | Radio button, one-up vertical | Single | N | |||
A civilian clinic or hospital | |||||||||
Not applicable | |||||||||
MMM00061 | Which of the following best describes your main reason for visiting our Web site today? | Find out what’s covered | Radio button, one-up vertical | Single | Y | Randomize | |||
Look up costs | |||||||||
Find a civilian/network provider | |||||||||
Find a military provider | |||||||||
Make an appointment | |||||||||
Referral | |||||||||
Look up a toll free phone number | |||||||||
File a claim | |||||||||
Check the status of a claim | |||||||||
Problem with a claim | |||||||||
Enroll | |||||||||
Pay Enrollment Fees | |||||||||
Pharmacy | |||||||||
Check eligibility | |||||||||
Update personal information | |||||||||
Learn about the plans / options | |||||||||
Look up health information / medical advice | |||||||||
Other (please explain) | A | ||||||||
MMM00062 | A | Other | Text field, <100 char | ||||||
MMM00063 | Where did you first go to find this information? | This web site was the first place I went | Radio button, one-up vertical | Single | Y | ||||
I went to a different Web site | |||||||||
I called a toll-free number | |||||||||
I read a TRICARE brochure or handbook | |||||||||
I visited a TRICARE Service Center | |||||||||
I visited a Military Treatment Facility | |||||||||
Other (please explain) | B | ||||||||
MMM00064 | B | Other | Text field, <100 char | ||||||
MMM00389 | Did you create a profile based on your beneficiary category, where you live and which TRICARE plan you’re in? | Yes | Radio button, one-up vertical | Single | |||||
No | |||||||||
AED05079 | Did you find what you were looking for on our Web site today? | Yes | |||||||
No | K, L | ||||||||
MMM00065 | K | If you did not find what you were looking for, what will you do now? | Try a different Web site | Radio button, one-up vertical | Single | N | |||
Call a toll-free number | |||||||||
Read a TRICARE brochure or handbook | |||||||||
Visit a TRICARE Service Center | |||||||||
Visit a Military Treatment Facility | |||||||||
Other | C | ||||||||
Not applicable | |||||||||
MMM00066 | C | Please explain what you will do now. | Text field, <100 char | ||||||
5926 | L | If you did not find what you were looking for on our Web site, what was it? | Text area, no char limit | N | |||||
51492 | What method are you primarily using to locate the information you are looking for? | Search Bar | H | Drop down, select one | Single | Y | SKIP LOGIC GROUP | ||
Clicking tabs or links | |||||||||
Site Map | |||||||||
Other | 1A | ||||||||
NEW | 1A | What other method are you using? | Text area, no char limit | ||||||
ACQOsl0002176 | H | Please describe your experience with the site's search feature? | I had no difficulty using the search feature on this site | Radio button, one-up vertical | Single | No | SKIP LOGIC GROUP | ||
The search feature was difficult to find | |||||||||
The search feature was difficult to use | |||||||||
Returned no results/received an error message | |||||||||
Could not tell where the search results would take me | |||||||||
Too many results | |||||||||
Too few results | |||||||||
Results were not related to what I was looking for | |||||||||
Could not sort the results | |||||||||
Could not refine the results | |||||||||
Other | 1B | ||||||||
NEW | 1B | What other experience did you have with the site's search feature? | Text area, no char limit | ||||||
ACQOsl0002177 | H | What key word(s) did you use to search? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
ACQOsl0002178 | H | Please indicate how helpful you feel the search feature was in finding the information you wanted/needed? | Very helpful | Radio button, one-up vertical | Single | No | SKIP LOGIC GROUP | ||
Somewhat helpful | I | ||||||||
Not at all helpful | I, J | ||||||||
ACQOsl0002179 | J | Why do you feel the search feature was not at all helpful? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
ACQOsl0002180 | I | What would make the search feature more helpful? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
MMM00056 | How did you get to our Web site today? | Referred by TRICARE brochure or handbook | Drop down, select one | Single | Y | ||||
Referred by TRICARE customer service representative | |||||||||
Typed in the address | |||||||||
Search engine (such as Google or Yahoo) | |||||||||
Bookmarks or Favorites | |||||||||
Link from another Web site | |||||||||
Other | |||||||||
5934 | If you could make one improvement to the site what would that be? | Text area, no char limit | N | ||||||
MMM00059 | Where are you located? | US (Continental) | Drop down, select one | Single | Y | ||||
Alaska | |||||||||
Hawaii | |||||||||
Pacific | |||||||||
Latin America | |||||||||
Canada | |||||||||
Europe | |||||||||
Puerto Rico/Virgin Islands | |||||||||
Other Overseas |
Model Instance Name: | |||||||||
DOD TRICARE | underlined & italicized: RE-ORDER | ||||||||
MID: EkBkYwMF5pUhJZssIpM89w== | pink: ADDITION | ||||||||
Date: | 2/22/2012 | blue + -->: REWORDING | |||||||
DOD TRICARE CUSTOM QUESTION LIST | |||||||||
CQID | 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 | |
5923 | How frequently do you visit our site? | First time | Drop down, select one | Single | Y | ||||
Every 6 months or less | |||||||||
About once a month | |||||||||
About once a week | |||||||||
Daily | |||||||||
More than once a day | |||||||||
MMM00067 | Which of the following best describes your role in visiting our site today? | TRICARE beneficiary | E, F, G | Radio button, one-up vertical | Single | Y | |||
Family, friend or caregiver of TRICARE beneficiary | |||||||||
Future TRICARE beneficiary | |||||||||
TRICARE Network Provider or Provider Staff | |||||||||
TRICARE Non-Network Provider or Provider Staff | |||||||||
Prospective TRICARE Provider or Provider Staff | |||||||||
Military Treatment Facility Clinical Staff | |||||||||
TRICARE Beneficiary Advisors and Customer Service Staff | |||||||||
All other Military Health System/TRICARE staff (Including government and supporting contractors) | |||||||||
Media/Researcher | |||||||||
Other | |||||||||
5929 | E | For TRICARE beneficiaries only- which best describes your status? | Active Duty Service Member | Radio button, one-up vertical | Single | N | |||
Family of Active Duty Service Member | |||||||||
Family of Deceased Active Duty Service Member | |||||||||
National Guard or Reserve Member (Activated) | |||||||||
Family of National Guard or Reserve Member (Activated) | |||||||||
National Guard or Reserve member (Non-Activated) | |||||||||
Family of National Guard or Reserve Member (Non-Activated) | |||||||||
Retired Service Member | |||||||||
Family of Retired Service Member | |||||||||
Family of Deceased Retired Service Member | |||||||||
Other Beneficiary | |||||||||
Not Applicable | |||||||||
MMM00068 | F | For TRICARE beneficiaries only: which of the following best describes your TRICARE enrollment option? | Sponsor is active duty (no premium paid) | Radio button, one-up vertical | |||||
Sponsor is active duty and family member has disenrolled from Prime to use TRICARE Standard | Single | N | |||||||
Sponsor is retired and we pay either $230/individual or $460/family per year Sponsor is retired and we pay either $260/individual or $520/family per year |
|||||||||
Sponsor is retired and we pay the Medicare Part B premium; TRICARE for Life | |||||||||
Sponsor is retired (and we do NOT pay either a TRICARE or Medicare Part B premium; TRICARE Standard) | |||||||||
Not applicable | |||||||||
5928 | G | For TRICARE beneficiaries only- do you receive most of your care from: | A military clinic or hospital | Radio button, one-up vertical | Single | N | |||
A civilian clinic or hospital | |||||||||
Not applicable | |||||||||
MMM00061 | Which of the following best describes your main reason for visiting our Web site today? | Find out what’s covered | Radio button, one-up vertical | Single | Y | Randomize | |||
Look up costs | |||||||||
Find a civilian/network provider | |||||||||
Find a military provider | |||||||||
Make an appointment | |||||||||
Look up a toll free phone number | |||||||||
File a claim | |||||||||
Check the status of a claim | |||||||||
Problem with a claim | |||||||||
Enroll | |||||||||
Pay Enrollment Fees | |||||||||
Pharmacy | |||||||||
Check eligibility | |||||||||
Update personal information | |||||||||
Learn about the plans / options | |||||||||
Look up health information / medical advice | |||||||||
Other (please explain) | A | ||||||||
MMM00062 | A | Other | Text field, <100 char | ||||||
MMM00063 | Where did you first go to find this information? | This web site was the first place I went | Radio button, one-up vertical | Single | Y | ||||
I went to a different Web site | |||||||||
I called a toll-free number | |||||||||
I read a TRICARE brochure or handbook | |||||||||
I visited a TRICARE Service Center | |||||||||
I visited a Military Treatment Facility | |||||||||
Other (please explain) | B | ||||||||
MMM00064 | B | Other | Text field, <100 char | ||||||
MMM00389 | Did you create a profile based on your beneficiary category, where you live and which TRICARE plan you’re in? | Yes | Radio button, one-up vertical | Single | |||||
No | |||||||||
AED05079 | Did you find what you were looking for on our Web site today? | Yes | |||||||
No | K, L | ||||||||
MMM00065 | K | If you did not find what you were looking for, what will you do now? | Try a different Web site | Radio button, one-up vertical | Single | N | |||
Call a toll-free number | |||||||||
Read a TRICARE brochure or handbook | |||||||||
Visit a TRICARE Service Center | |||||||||
Visit a Military Treatment Facility | |||||||||
Other | C | ||||||||
Not applicable | |||||||||
MMM00066 | C | Please explain what you will do now. | Text field, <100 char | ||||||
5926 | L | If you did not find what you were looking for on our Web site, what was it? | Text area, no char limit | N | |||||
51492 | What method are you primarily using to locate the information you are looking for? | Search Bar | H | Drop down, select one | Single | Y | SKIP LOGIC GROUP | ||
Clicking tabs or links | |||||||||
Site Map | |||||||||
Other | |||||||||
ACQOsl0002176 | H | Please describe your experience with the site's search feature? | I had no difficulty using the search feature on this site | Radio button, one-up vertical | Single | No | SKIP LOGIC GROUP | ||
The search feature was difficult to find | |||||||||
The search feature was difficult to use | |||||||||
Returned no results/received an error message | |||||||||
Could not tell where the search results would take me | |||||||||
Too many results | |||||||||
Too few results | |||||||||
Results were not related to what I was looking for | |||||||||
Could not sort the results | |||||||||
Could not refine the results | |||||||||
Other | |||||||||
ACQOsl0002177 | H | What key word(s) did you use to search? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
ACQOsl0002178 | H | Please indicate how helpful you feel the search feature was in finding the information you wanted/needed? | Very helpful | Radio button, one-up vertical | Single | No | SKIP LOGIC GROUP | ||
Somewhat helpful | I | ||||||||
Not at all helpful | I, J | ||||||||
ACQOsl0002179 | J | Why do you feel the search feature was not at all helpful? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
ACQOsl0002180 | I | What would make the search feature more helpful? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
MMM00056 | How did you get to our Web site today? | Referred by TRICARE brochure or handbook | Drop down, select one | Single | Y | ||||
Referred by TRICARE customer service representative | |||||||||
Typed in the address | |||||||||
Search engine (such as Google or Yahoo) | |||||||||
Bookmarks or Favorites | |||||||||
Link from another Web site | |||||||||
Other | |||||||||
5934 | If you could make one improvement to the site what would that be? | Text area, no char limit | N | ||||||
MMM00059 | Where are you located? | US (Continental) | Drop down, select one | Single | Y | ||||
Alaska | |||||||||
Hawaii | |||||||||
Pacific | |||||||||
Latin America | |||||||||
Canada | |||||||||
Europe | |||||||||
Puerto Rico/Virgin Islands | |||||||||
Other Overseas |
Model Instance Name: | |||||||||
DOD TRICARE | underlined & italicized: RE-ORDER | ||||||||
MID: EkBkYwMF5pUhJZssIpM89w== | pink: ADDITION | ||||||||
Date: | 10/15/2010 | blue + -->: REWORDING | |||||||
DOD TRICARE CUSTOM QUESTION LIST | |||||||||
QID | 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 | |
5923 | How frequently do you visit our site? | First time | Drop down, select one | Single | Y | ||||
Every 6 months or less | |||||||||
About once a month | |||||||||
About once a week | |||||||||
Daily | |||||||||
More than once a day | |||||||||
MMM00067 | Which of the following best describes your role in visiting our site today? | TRICARE beneficiary | E, F, G | Radio button, one-up vertical | Single | Y | |||
Family, friend or caregiver of TRICARE beneficiary | |||||||||
Future TRICARE beneficiary | |||||||||
TRICARE Network Provider or Provider Staff | |||||||||
TRICARE Non-Network Provider or Provider Staff | |||||||||
Prospective TRICARE Provider or Provider Staff | |||||||||
Military Treatment Facility Clinical Staff | |||||||||
TRICARE Beneficiary Advisors and Customer Service Staff | |||||||||
All other Military Health System/TRICARE staff (Including government and supporting contractors) | |||||||||
Media/Researcher | |||||||||
Other | |||||||||
5929 | SKIP E | For TRICARE beneficiaries only- which best describes your status? | Active Duty Service Member | Radio button, one-up vertical | Single | N | |||
Family of Active Duty Service Member | |||||||||
Family of Deceased Active Duty Service Member | |||||||||
National Guard or Reserve Member (Activated) | |||||||||
Family of National Guard or Reserve Member (Activated) | |||||||||
National Guard or Reserve member (Non-Activated) | |||||||||
Family of National Guard or Reserve Member (Non-Activated) | |||||||||
Retired Service Member | |||||||||
Family of Retired Service Member | |||||||||
Family of Deceased Retired Service Member | |||||||||
Other Beneficiary | |||||||||
Not Applicable | |||||||||
MMM00068 | SKIP F | For TRICARE beneficiaries only: which of the following best describes your TRICARE enrollment option? | Sponsor is active duty (no premium paid) | Radio button, one-up vertical | |||||
Sponsor is active duty and family member has disenrolled from Prime to use TRICARE Standard | Single | N | |||||||
Sponsor is retired and we pay either $230/individual or $460/family per year | |||||||||
Sponsor is retired and we pay the Medicare Part B premium; TRICARE for Life | |||||||||
Sponsor is retired (and we do NOT pay either a TRICARE or Medicare Part B premium; TRICARE Standard) | |||||||||
Not applicable | |||||||||
5928 | SKIP G | For TRICARE beneficiaries only- do you receive most of your care from: | A military clinic or hospital | Radio button, one-up vertical | Single | N | |||
A civilian clinic or hospital | |||||||||
Not applicable | |||||||||
MMM00061 | Which of the following best describes your main reason for visiting our Web site today? | Find out what’s covered | Radio button, one-up vertical | Single | Y | Randomize | |||
Look up costs | |||||||||
Find a civilian/network provider | |||||||||
Find a military provider | |||||||||
Make an appointment | |||||||||
Look up a toll free phone number | |||||||||
File a claim | |||||||||
Check the status of a claim | |||||||||
Problem with a claim | |||||||||
Enroll | |||||||||
Pay Enrollment Fees | |||||||||
Pharmacy | |||||||||
Check eligibility | |||||||||
Update personal information | |||||||||
Learn about the plans / options | |||||||||
Look up health information / medical advice | |||||||||
Other (please explain) | A | ||||||||
MMM00062 | A | Other | Text field, <100 char | ||||||
MMM00063 | Where did you first go to find this information? | This web site was the first place I went | Radio button, one-up vertical | Single | Y | ||||
I went to a different Web site | |||||||||
I called a toll-free number | |||||||||
I read a TRICARE brochure or handbook | |||||||||
I visited a TRICARE Service Center | |||||||||
I visited a Military Treatment Facility | |||||||||
Other (please explain) | B | ||||||||
MMM00064 | B | Other | Text field, <100 char | ||||||
MMM00389 | Did you create a profile based on your beneficiary category, where you live and which TRICARE plan you’re in? | Yes | Radio button, one-up vertical | Single | |||||
No | |||||||||
AED05079 | Did you find what you were looking for on our Web site today? | Yes | |||||||
No | K, L | ||||||||
MMM00065 | SKIP K | If you did not find what you were looking for, what will you do now? | Try a different Web site | Radio button, one-up vertical | Single | N | |||
Call a toll-free number | |||||||||
Read a TRICARE brochure or handbook | |||||||||
Visit a TRICARE Service Center | |||||||||
Visit a Military Treatment Facility | |||||||||
Other | C | ||||||||
Not applicable | |||||||||
MMM00066 | C | Please explain what you will do now. | Text field, <100 char | ||||||
5926 | SKIP L | If you did not find what you were looking for on our Web site, what was it? | Text area, no char limit | N | |||||
51492 | What method are you primarily using to locate the information you are looking for? | Search Bar | H | Drop down, select one | Single | Y | SKIP LOGIC GROUP | ||
Clicking tabs or links | |||||||||
Site Map | |||||||||
Other | |||||||||
ACQOsl0002176 | H | Please describe your experience with the site's search feature? | I had no difficulty using the search feature on this site | Radio button, one-up vertical | Single | No | SKIP LOGIC GROUP | ||
The search feature was difficult to find | |||||||||
The search feature was difficult to use | |||||||||
Returned no results/received an error message | |||||||||
Could not tell where the search results would take me | |||||||||
Too many results | |||||||||
Too few results | |||||||||
Results were not related to what I was looking for | |||||||||
Could not sort the results | |||||||||
Could not refine the results | |||||||||
Other | |||||||||
ACQOsl0002177 | H | What key word(s) did you use to search? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
ACQOsl0002178 | H | Please indicate how helpful you feel the search feature was in finding the information you wanted/needed? | Very helpful | Radio button, one-up vertical | Single | No | SKIP LOGIC GROUP | ||
Somewhat helpful | I | ||||||||
Not at all helpful | I, J | ||||||||
ACQOsl0002179 | J | Why do you feel the search feature was not at all helpful? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
ACQOsl0002180 | I | What would make the search feature more helpful? | Text area, no char limit | No | SKIP LOGIC GROUP | ||||
MMM00056 | How did you get to our Web site today? | Referred by TRICARE brochure or handbook | Drop down, select one | Single | Y | ||||
Referred by TRICARE customer service representative | |||||||||
Typed in the address | |||||||||
Search engine (such as Google or Yahoo) | |||||||||
Bookmarks or Favorites | |||||||||
Link from another Web site | |||||||||
Other | |||||||||
5934 | If you could make one improvement to the site what would that be? | Text area, no char limit | N | ||||||
MMM00059 | Where are you located? | US (Continental) | Drop down, select one | Single | Y | ||||
Alaska | |||||||||
Hawaii | |||||||||
Pacific | |||||||||
Latin America | |||||||||
Canada | |||||||||
Europe | |||||||||
Puerto Rico/Virgin Islands | |||||||||
Other Overseas |
Model Instance Name: | ||||||||
DOD TRICARE | underlined & italicized: RE-ORDER | |||||||
MID: EkBkYwMF5pUhJZssIpM89w== | pink: ADDITION | |||||||
Date: | 11/10/2008 | blue + -->: REWORDING | ||||||
DOD TRICARE CUSTOM QUESTION LIST | ||||||||
QID | 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 |
5923 | How frequently do you visit our site? | First time | Drop down, select one | Single | Y | |||
Every 6 months or less | ||||||||
About once a month | ||||||||
About once a week | ||||||||
Daily | ||||||||
More than once a day | ||||||||
MMM00067 | Which of the following best describes your role in visiting our site today? | TRICARE beneficiary | E, F, G | Radio button, one-up vertical | Single | Y | ||
Family, friend or caregiver of TRICARE beneficiary | ||||||||
Future TRICARE beneficiary | ||||||||
TRICARE Network Provider or Provider Staff | ||||||||
TRICARE Non-Network Provider or Provider Staff | ||||||||
Prospective TRICARE Provider or Provider Staff | ||||||||
Military Treatment Facility Clinical Staff | ||||||||
TRICARE Beneficiary Advisors and Customer Service Staff | ||||||||
All other Military Health System/TRICARE staff (Including government and supporting contractors) | ||||||||
Media/Researcher | ||||||||
Other | ||||||||
5929 | SKIP E | For TRICARE beneficiaries only- which best describes your status? | Active Duty Service Member | Radio button, one-up vertical | Single | N | ||
Family of Active Duty Service Member | ||||||||
Family of Deceased Active Duty Service Member | ||||||||
National Guard or Reserve Member (Activated) | ||||||||
Family of National Guard or Reserve Member (Activated) | ||||||||
National Guard or Reserve member (Non-Activated) | ||||||||
Family of National Guard or Reserve Member (Non-Activated) | ||||||||
Retired Service Member | ||||||||
Family of Retired Service Member | ||||||||
Family of Deceased Retired Service Member | ||||||||
Other Beneficiary | ||||||||
Not Applicable | ||||||||
MMM00068 | SKIP F | For TRICARE beneficiaries only: which of the following best describes your TRICARE enrollment option? | Sponsor is active duty (no premium paid) | Radio button, one-up vertical | ||||
Sponsor is active duty and family member has disenrolled from Prime to use TRICARE Standard | Single | N | ||||||
Sponsor is retired and we pay either $230/individual or $460/family per year | ||||||||
Sponsor is retired and we pay the Medicare Part B premium; TRICARE for Life | ||||||||
Sponsor is retired (and we do NOT pay either a TRICARE or Medicare Part B premium; TRICARE Standard) | ||||||||
Not applicable | ||||||||
5928 | SKIP G | For TRICARE beneficiaries only- do you receive most of your care from: | A military clinic or hospital | Radio button, one-up vertical | Single | N | ||
A civilian clinic or hospital | ||||||||
Not applicable | ||||||||
MMM00061 | Which of the following best describes your main reason for visiting our Web site today? | Find out what’s covered | Radio button, one-up vertical | Single | Y | |||
Look up costs | ||||||||
Find a civilian/network provider | ||||||||
Find a military provider | ||||||||
Make an appointment | ||||||||
Look up a toll free phone number | ||||||||
File a claim | ||||||||
Check the status of a claim | ||||||||
Problem with a claim | ||||||||
Enroll | ||||||||
Pay Enrollment Fees | ||||||||
Pharmacy | ||||||||
Check eligibility | ||||||||
Update personal information | ||||||||
Learn about the plans / options | ||||||||
Look up health information / medical advice | ||||||||
Other (please explain) | A | |||||||
MMM00062 | A | Other | Text field, <100 char | |||||
MMM00063 | Where did you first go to find this information? | This web site was the first place I went | Radio button, one-up vertical | Single | Y | |||
I went to a different Web site | ||||||||
I called a toll-free number | ||||||||
I read a TRICARE brochure or handbook | ||||||||
I visited a TRICARE Service Center | ||||||||
I visited a Military Treatment Facility | ||||||||
Other (please explain) | B | |||||||
MMM00064 | B | Other | Text field, <100 char | |||||
MMM00389 | Did you create a profile based on your beneficiary category, where you live and which TRICARE plan you’re in? | Yes | Radio button, one-up vertical | Single | ||||
No | ||||||||
AED05079 | Did you find what you were looking for on our Web site today? | Yes | ||||||
No | H, I | |||||||
MMM00065 | SKIP H | If you did not find what you were looking for, what will you do now? | Try a different Web site | Radio button, one-up vertical | Single | N | ||
Call a toll-free number | ||||||||
Read a TRICARE brochure or handbook | ||||||||
Visit a TRICARE Service Center | ||||||||
Visit a Military Treatment Facility | ||||||||
Other | C | |||||||
Not applicable | ||||||||
MMM00066 | C | Please explain what you will do now. | Text field, <100 char | |||||
5926 | SKIP I | If you did not find what you were looking for on our Web site, what was it? | Text area, no char limit | N | ||||
51492 | What method are you primarily using to locate the information you are looking for? | Search Bar | Drop down, select one | Single | Y | |||
Clicking tabs or links | ||||||||
Site Map | ||||||||
Other | ||||||||
MMM00056 | How did you get to our Web site today? | Referred by TRICARE brochure or handbook | Drop down, select one | Single | Y | |||
Referred by TRICARE customer service representative | ||||||||
Typed in the address | ||||||||
Search engine (such as Google or Yahoo) | ||||||||
Bookmarks or Favorites | ||||||||
Link from another Web site | ||||||||
Other | ||||||||
5934 | If you could make one improvement to the site what would that be? | Text area, no char limit | N | |||||
MMM00059 | Where are you located? | US (Continental) | Drop down, select one | Single | Y | |||
Alaska | ||||||||
Hawaii | ||||||||
Pacific | ||||||||
Latin America | ||||||||
Canada | ||||||||
Europe | ||||||||
Puerto Rico/Virgin Islands | ||||||||
Other Overseas | ||||||||
NOTE: Following questions do not appear on survey. | ||||||||
MMM00060 | Have you done any of the following activities in the past 90 days? | Applied for a job online | Multi | Y | ||||
Listed an item to sell in an online auction or online classified ad | ||||||||
Made a purchase online | ||||||||
Managed personal finances online | ||||||||
Researched a major purchase item online | ||||||||
None of these | ||||||||
MMM00057 | What is your gender? | Male | Single | Y | ||||
Female | ||||||||
MMM00058 | What is your age? | Less than 18 | Single | Y | ||||
18 to 24 | ||||||||
25 to 34 | ||||||||
35 to 44 | ||||||||
45 to 64 | ||||||||
65 and better |
Model Instance Name: | ||||||||
DOD TRICARE | underlined & italicized: RE-ORDER | |||||||
MID: EkBkYwMF5pUhJZssIpM89w== | pink: ADDITION | |||||||
Date: | 11/10/2008 | blue + -->: REWORDING | ||||||
DOD TRICARE CUSTOM QUESTION LIST | ||||||||
QID | 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 |
5923 | How frequently do you visit our site? | First time | Drop down, select one | Single | Y | |||
Every 6 months or less | ||||||||
About once a month | ||||||||
About once a week | ||||||||
Daily | ||||||||
More than once a day | ||||||||
MMM00067 | Which of the following best describes your role in visiting our site today? | TRICARE beneficiary | E, F, G | Radio button, one-up vertical | Single | Y | ||
Family, friend or caregiver of TRICARE beneficiary | ||||||||
Future TRICARE beneficiary | ||||||||
TRICARE Network Provider or Provider Staff | ||||||||
TRICARE Non-Network Provider or Provider Staff | ||||||||
Prospective TRICARE Provider or Provider Staff | ||||||||
Military Treatment Facility Clinical Staff | ||||||||
TRICARE Beneficiary Advisors and Customer Service Staff | ||||||||
All other Military Health System/TRICARE staff (Including government and supporting contractors) | ||||||||
Media/Researcher | ||||||||
Other | ||||||||
5929 | SKIP E | For TRICARE beneficiaries only- which best describes your status? | Active Duty Service Member | Radio button, one-up vertical | Single | N | ||
Family of Active Duty Service Member | ||||||||
Family of Deceased Active Duty Service Member | ||||||||
National Guard or Reserve Member (Activated) | ||||||||
Family of National Guard or Reserve Member (Activated) | ||||||||
National Guard or Reserve member (Non-Activated) | ||||||||
Family of National Guard or Reserve Member (Non-Activated) | ||||||||
Retired Service Member | ||||||||
Family of Retired Service Member | ||||||||
Family of Deceased Retired Service Member | ||||||||
Other Beneficiary | ||||||||
Not Applicable | ||||||||
MMM00068 | SKIP F | For TRICARE beneficiaries only: which of the following best describes your TRICARE enrollment option? | Sponsor is active duty (no premium paid) | Radio button, one-up vertical | ||||
Sponsor is active duty and family member has disenrolled from Prime to use TRICARE Standard | Single | N | ||||||
Sponsor is retired and we pay either $230/individual or $460/family per year | ||||||||
Sponsor is retired and we pay the Medicare Part B premium; TRICARE for Life | ||||||||
Sponsor is retired (and we do NOT pay either a TRICARE or Medicare Part B premium; TRICARE Standard) | ||||||||
Not applicable | ||||||||
5928 | SKIP G | For TRICARE beneficiaries only- do you receive most of your care from: | A military clinic or hospital | Radio button, one-up vertical | Single | N | ||
A civilian clinic or hospital | ||||||||
Not applicable | ||||||||
MMM00061 | Which of the following best describes your main reason for visiting our Web site today? | Find out what’s covered | Radio button, one-up vertical | Single | Y | |||
Look up costs | ||||||||
Find a civilian/network provider | ||||||||
Find a military provider | ||||||||
Make an appointment | ||||||||
Look up a toll free phone number | ||||||||
File a claim | ||||||||
Check the status of a claim | ||||||||
Problem with a claim | ||||||||
Enroll | ||||||||
Pay Enrollment Fees | ||||||||
Check eligibility | ||||||||
Update personal information | ||||||||
Learn about the plans / options | ||||||||
Look up health information / medical advice | ||||||||
Other (please explain) | A | |||||||
A | Other | Text field, <100 char | ||||||
MMM00063 | Where did you first go to find this information? | This web site was the first place I went | Radio button, one-up vertical | Single | Y | |||
I went to a different Web site | ||||||||
I called a toll-free number | ||||||||
I read a TRICARE brochure or handbook | ||||||||
I visited a TRICARE Service Center | ||||||||
I visited a Military Treatment Facility | ||||||||
Other (please explain) | B | |||||||
MMM00064 | B | Other | Text field, <100 char | |||||
MMM00389 | Did you create a profile based on your beneficiary category, where you live and which TRICARE plan you’re in? | Yes | Radio button, one-up vertical | Single | ||||
No | ||||||||
NEW | Did you find what you were looking for on our Web site today? | Yes | ||||||
No | H, I | |||||||
MMM00065 | SKIP H | If you did not find what you were looking for, what will you do now? | Try a different Web site | Radio button, one-up vertical | Single | N | ||
Call a toll-free number | ||||||||
Read a TRICARE brochure or handbook | ||||||||
Visit a TRICARE Service Center | ||||||||
Visit a Military Treatment Facility | ||||||||
Other (please explain) | C | |||||||
Not applicable | ||||||||
MMM00066 | C | Please explain what you will do now. | Text field, <100 char | |||||
5926 | SKIP I | If you did not find what you were looking for on our Web site, what was it? | Text area, no char limit | N | ||||
51492 | What method are you primarily using to locate the information you are looking for? | Search Bar | Drop down, select one | Single | Y | |||
Clicking tabs or links | ||||||||
Site Map | ||||||||
Other | ||||||||
MMM00056 | How did you get to our Web site today? | Referred by TRICARE brochure or handbook | Drop down, select one | Single | Y | |||
Referred by TRICARE customer service representative | ||||||||
Typed in the address | ||||||||
Search engine (such as Google or Yahoo) | ||||||||
Bookmarks or Favorites | ||||||||
Link from another Web site | ||||||||
Other | ||||||||
5934 | If you could make one improvement to the site what would that be? | Text area, no char limit | N | |||||
MMM00059 | Where are you located? | US (Continental) | Drop down, select one | Single | Y | |||
Alaska | ||||||||
Hawaii | ||||||||
Pacific | ||||||||
Latin America | ||||||||
Canada | ||||||||
Europe | ||||||||
Puerto Rico/Virgin Islands | ||||||||
Other Overseas | ||||||||
NOTE: Following questions do not appear on survey. | ||||||||
MMM00060 | Have you done any of the following activities in the past 90 days? | Applied for a job online | Multi | Y | ||||
Listed an item to sell in an online auction or online classified ad | ||||||||
Made a purchase online | ||||||||
Managed personal finances online | ||||||||
Researched a major purchase item online | ||||||||
None of these | ||||||||
MMM00057 | What is your gender? | Male | Single | Y | ||||
Female | ||||||||
MMM00058 | What is your age? | Less than 18 | Single | Y | ||||
18 to 24 | ||||||||
25 to 34 | ||||||||
35 to 44 | ||||||||
45 to 64 | ||||||||
65 and better |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |