Form 754 2014 754 VA-SEP

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Overview

Welcome and Thank You Text
Current Model Qsts
Current CQs

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Sheet 1: Welcome and Thank You Text

Model Instance Name:
VA - SEP
MID:	Existing Measure - Please fill in; New Measure - DOT will fill in
Date:	1/27/2014
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
	bharati.hulbanni: if STORES MEASURE: do NOT use any welcome text. Thank you for visiting our site. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible.
					Thank You Text Example
	DEFAULT Thank You Text
	bharati.hulbanni: TY text can be used for all measure types (call center, web, stores, mobile etc.) Thank you for taking our survey - and for helping us serve you better. We appreciate your input!
	ALTERNATE WEB Thank You Text
	bharati.hulbanni: Use this TY text ONLY for WEB 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.

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Sheet 2: Current Model Qsts

Model Instance Name:
VA - SEP
MID:		Existing Measure - Please fill in; New Measure - DOT will fill in
Partitioned (Y/N)?			Y
FPI Included(Y/N)?			N
NOTE: All non-partitioned surveys will NOT be imputed and the elements will be rotated as a default unless otherwise specified and approved by Research.
Date:		1/27/2014
VA - SEP
Model questions utilize the ForeSee CXA methodology to determine scores and impacts
		ELEMENTS (drivers of satisfaction)			CUSTOMER SATISFACTION			FUTURE BEHAVIORS	FPI
	MQ Label			MQ Label			MQ Label		Y?
		Content (1=Poor, 10=Excellent, Don't Know)			Satisfaction (1=Poor, 10=Excellent)			Likelihood to Return (1=Not Very Likely, 10=Very Likely)
1	Content - Accuracy	Please rate the accuracy of information on this site.	16	Satisfaction - Overall	What is your overall satisfaction with this site?	19	Return	How likely are you to return to this site?
2	Content - Quality	Please rate the quality of information on this site.	17	Satisfaction - Expectations	How well does this site meet your expectations?			Recommend (1=Not Very Likely, 10=Very Likely)
3	Content - Freshness	Please rate the freshness of content on this site.	18	Satisfaction - Ideal	How does this site compare to your idea of an ideal website?	20	Recommend	How likely are you to recommend this site to someone else?
		Site Performance (1=Poor, 10=Excellent, Don't Know)						Primary Resource (1=Not Very Likely, 10=Very Likely)
4	Site Performance - Loading	Please rate how quickly pages load on this site.				21	Primary Resource	How likely are you to use this site as your primary resource for obtaining information from this organization?
5	Site Performance - Consistency	Please rate the consistency of speed from page to page on this site.						Use Web Channel Over Others (1=Very Unlikely, 10=Very Likely)
6	Site Performance - Completeness	Please rate how completely the page content loads on this site.				22	Use Web Channel Over Others	How likely are you to use this site rather than seeking information from other channels?
		Functionality (1=Poor, 10=Excellent, Don't Know)
7	Functionality - Usefulness	Please rate the usefulness of the website tools provided on this site.
8	Functionality - Convenient	Please rate the convenient placement of the website tools on this site.
9	Functionality - Variety	Please rate the variety of website tools on this site.
		Look and Feel (1=Poor, 10=Excellent, Don't Know)
10	Look and Feel - Appeal	Please rate the visual appeal of this site.
11	Look and Feel - Balance	Please rate the balance of graphics and text on this site.
12	Look and Feel - Readability	Please rate the readability of the pages on this site.
		Navigation (1=Poor, 10=Excellent, Don't Know)
13	Navigation - Organized	Please rate how well the site is organized.
14	Navigation - Options	Please rate the options available for navigating this site.
15	Navigation - Layout	Please rate how well the site layout helps you find what you need.

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Sheet 3: Current CQs

Model Instance Name:

red & strike-through: DELETE

VA - SEP

underlined & italicized: RE-ORDER

MID: Existing Measure - Please fill in; New Measure - DOT will fill in

pink: ADDITION

Date:

1/27/2014

blue + -->: REWORDING

VA - SEP CUSTOM QUESTION LIST

bharati.hulbanni: Hide (DO NOT DELETE) this column before sending to a client. QID

FPI Y?

bharati.hulbanni: there should be NO MORE THAN ONE LETTER IN HERE (Skip Logic Label) Skip Logic Label

Question Text

bharati.hulbanni: Hide (DO NOT DELETE) this column before sending to a client. AnswerIDs (DOT)

Answer Choices (limited to 50 characters)

Skip to

Type (select from list)

Single or Multi

Required Y/N

bharati.hulbanni: Can not have more than one CQ GroupType (denoted by an *) within one colored group in 'Special Instructions' . Special Instructions

CQ Label

Which of the following best describes your role in visiting the Stakeholder Enterprise Portal (SEP) site today? (Select all that apply)

Veteran Service Organization (VSO)

Checkbox, one-up vertical

Multi

Y

Skip Logic Group*

Role

Education Provider

Doctor or Other Health Care Provider

Attorney

Loan Appraiser

Benefit Provider

Other, please specify:

A

A

Please specify your role in visiting the SEP site.

Text area, no char limit

N

Skip Logic Group*

OE_Role

How frequently do you visit this site?

First time

Radio button, one-up vertical

Single

Y

Visit Frequency

Daily

About once a week

About once a month

About once or twice a year

Less frequently than once a year

For which reasons did you visit the SEP site today? (Select all that apply)

Access information

Checkbox, one-up vertical

Multi

Y

Skip Logic Group*

Visit Reason

Submit claims on my own behalf

Submit claims on a veteran's behalf

Apply for benefits

A

Check the status of a claim for benefits

A

Check the status of an appeal for a claim for benefits

A

Check the status of a benefit payment

To view a veteran's benefit payment history

Obtain a benefit verification letter

Change my profile (e.g.,. change contact information)

Just browsing/Curious what site offered

Other, please specify:

B

B

Why else were you visiting the SEP site today?

Text area, no char limit

N

Skip Logic Group*

OE_Visit Reason

A

What type of benefit status were you applying for or checking on today? (Select all that apply)

Compensation

Checkbox, one-up vertical

Multi

N

Skip Logic Group*

Benefit Type

Pension

Education

Which of the following areas of the SEP site did you visit today? (Select all that apply)

Compensation Service

Checkbox, one-up vertical

Multi

Y

Skip Logic Group*

Areas Visited

Education Service

Purchased Care @ Health Administration Center (PC@HAC)

Vocational Rehabilitation & Employment (VR&E)

Veterans Service Organizations (VSO)

FAQs

KnowVA

FAST Letters (1996 - Present)

Learn More About SEP

Other section not listed above

A

Not sure

A

Please specify which other section(s) you visited.

Text area, no char limit

N

Skip Logic Group*

OE_Areas Visited

Did you accomplish what you wanted to on the site today?

Yes

Radio button, one-up vertical

Single

Y

Skip Logic Group

Task Accomplishment

Partially

A, B

No

A, B

I wasn’t planning to accomplish anything in particular

A

What were you unable to accomplish on the site? Please be specific.

Text area, no char limit

N

Skip Logic Group*

OE_Task Accomplish

B

What do you plan to do next? (Select all that apply)

Continue looking for the information on this site

Checkbox, one-up vertical

Multi

N

Skip Logic Group*

Do Next

Return to this site later and try again

Conduct a new internet search

Visit other websites

Call the VA

C

Other, please specify:

C

Please specify what you plan to do next.

N

Skip Logic Group*

OE_Do Next

Did you try to log in on this site today?

Yes

A

Radio button, one-up vertical

Single

Y

Skip Logic Group*

Log In Attempt

No

A

Were you able to log in successfully?

Yes, the first time I tried

B

Radio button, one-up vertical

Single

Y

Skip Logic Group*

Log In Success

Yes, after more than one try

B

No, I was unable to log in

C, B

C

Why were you unable to log in?

Text area, no char limit

N

Skip Logic Group*

OE_Log In Unsuccessful

B

What, if anything, would you like improved about the log in process?

Text area, no char limit

N

Skip Logic Group*

OE_Log In Improvement

Thinking about the SEP homepage, was it clear where you needed to go to find what you were looking for today?

Yes

Radio button, one-up vertical

Single

N

Skip Logic Group

Homepage Carity

No

A

A

What could have improved your ability to find what you were looking for from the SEP homepage?

Text area, no char limit

N

OE_Homepage Improvement

How would you describe your navigation experience on the SEP site today? (Select all that apply)

DOT - please anchor this answer choice and make it mutually exclusive so that if selected, other options become grayed out.

I had no difficulty navigating/browsing on this site

Checkbox, one-up vertical

Multi

N

Skip Logic Group*

Nav Experience

Links often did not take me where I expected

Randomize

Had difficulty finding relevant information/products

Links/labels are difficult to understand

Too many links/navigational options to choose from

Had technical difficulties (error messages, broken links, etc.)

Could not navigate back to previous information

I had a navigation difficulty not listed above

A

Anchor Answer Choice

A

Please specify the navigation difficulty you had.

Text area, no char limit

Skip Logic Group*

OE_Nav Difficulty

If you could identify one improvement to this site, what improvement would you suggest?

Text area, no char limit

Single

N

OE_One Improvement