Form 0 Customer Satisfaction Survey

OMB Approved:

            No. 3206-0236

OPM Customer Satisfaction Survey

Standard Form

Public Burden Statement:

We estimate this form takes an average of 15 minutes to complete including the time for getting the needed data and reviewing both the instructions and completed form. Send comments regarding our estimate or any other aspect of this form, including suggestions for reducing completion time, to the Office of Personnel Management (OPM), Assessment Services, Steve Burnkrant (3206-0236), 1900 E. Street N.W., Washington, DC 20415-7900. The OMB Number, 3206-0236, is currently valid. OPM may not collect this information, and you are not required to respond, unless this number is displayed.

Background Information

Access

1. What difficulties, if any, have you experienced in trying to find someone from the XYZ staff to assist you? (Mark all that apply)

O	Not applicable; I have not contacted XYZ in the last 12 months
O	No difficulties
O	Difficulty with automated "800" number
O	Telephone rang without answer or stayed busy
O	Telephone messages are not returned
O	Telephone call transferred multiple times
O	Kept on hold
O	No response e-mail messages
O	E-mail forwarded multiple times
O	Difficulty getting through to the fax number
O	Faxes answered slowly
O	Other

2. How do you usually request XYZ information, services, or products? (Mark all that apply)

O	Not applicable; I have not made a request in the last 12 months
O	Telephone
O	E-mail
O	Website
O	Fax
O	Mail
O	Visit

3. How would you prefer to receive Vendor Pay/Transportation Pay information, services, or products? (Mark all that apply)

O	Not applicable; I rarely contact the XYZ staff to request assistance
O	Telephone
O	E-mail
O	Website
O	Fax
O	Mail
O	Visit

	Strongly Disagree	Disagree	Neither	Agree	Strongly Agree	No Basis to Judge
It is easy to do business with XYZ.	O	O	O	O	O	O
Assistance from the XYZ staff is provided at a time that is convenient to me.	O	O	O	O	O	O
It is easy to find someone at XYZ who can answer my questions.	O	O	O	O	O	O
I do not have to cut through a lot of red tape to reach higher level XYZ officials.	O	O	O	O	O	O
I have adequate access to XYZ staff for advice and assistance.	O	O	O	O	O	O
the XYZ staff keeps me informed about conditions and changes that affect me.	O	O	O	O	O	O

Courtesy

	Strongly Disagree	Disagree	Neither	Agree	Strongly Agree	No Basis to Judge
The XYZ staff is always willing to help me.	O	O	O	O	O	O
The XYZ staff is courteous.	O	O	O	O	O	O
The XYZ staff gives individual attention my requests for information or service.	O	O	O	O	O	O

Knowledge

	Strongly Disagree	Disagree	Neither	Agree	Strongly Agree	No Basis to Judge
The XYZ staff is knowledgeable.	O	O	O	O	O	O
The XYZ staff has a good understanding of my organization’s operation and mission.	O	O	O	O	O	O
Explanations of technical issues are understandable.	O	O	O	O	O	O
The XYZ staff is able to explain their products and services.	O	O	O	O	O	O
When someone at XYZ does not know the answer, they refer me to an expert who does.	O	O	O	O	O	O

Timeliness

	Strongly Disagree	Disagree	Neither	Agree	Strongly Agree	No Basis to Judge
The XYZ staff provides timely service for each of the following:
	O	O	O	O	O	O
	O	O	O	O	O	O
Overall, the XYZ staff provides timely service.	O	O	O	O	O	O

Reliability

	Strongly Disagree	Disagree	Neither	Agree	Strongly Agree	No Basis to Judge
The XYZ staff gives me accurate information.	O	O	O	O	O	O
The XYZ staff keeps accurate records.	O	O	O	O	O	O
The XYZ staff provides services when promised.	O	O	O	O	O	O
The XYZ staff provides reliable and consistent service.	O	O	O	O	O	O

Choice

	Strongly Disagree	Disagree	Neither	Agree	Strongly Agree	No Basis to Judge
XYZ products and services are designed to meet customer needs.	O	O	O	O	O	O
The XYZ staff uses suggestions from their customers to improve the quality of products and services.	O	O	O	O	O	O
I am satisfied with the range of products and services provided by XYZ.	O	O	O	O	O	O

Tangibles

	Strongly Disagree	Disagree	Neither	Agree	Strongly Agree	No Basis to Judge
The XYZ staff works in offices that are visually appealing.	O	O	O	O	O	O
The XYZ staff presents a professional appearance.	O	O	O	O	O	O
I am satisfied with the appearance of websites, manuals, brochures, reports, and other communication materials prepared by XYZ.	O	O	O	O	O	O

Recovery

	Strongly Disagree	Disagree	Neither	Agree	Strongly Agree	No Basis to Judge
Problems and complains are resolved quickly.	O	O	O	O	O	O
Problems and complaints are resolved with minimal effort on the customer’s part.	O	O	O	O	O	O
There are well defined systems for linking customer feedback and complaints to employees who can act on this information.	O	O	O	O	O	O
The XYZ staff is flexible in finding solutions to problems.	O	O	O	O	O	O
I am satisfied with the way the XYZ staff handled problems or mistakes.	O	O	O	O	O	O

Quality

	Very Poor	Poor	Fair	Good	Very Good	No Basis to Judge
How would you rate the quality of the following products and services:
	O	O	O	O	O	O
	O	O	O	O	O	O
Overall, how would you rate the quality of products and services provided by XYZ?	O	O	O	O	O	O

Overall Satisfaction

37. Overall, how satisfied are you with the services you are receiving from XYZ?

O	Very Dissatisfied
O	Dissatisfied
O	Neither Satisfied nor Dissatisfied
O	Satisfied
O	Very Satisfied

38. If you had a choice of service providers, would you use XYZ again?

O	Yes
O	No
O	Not Sure

39. If you had a choice of service providers, would you recommend XYZ to others?

O	Yes
O	No
O	Not Sure

40. Based on the service you have received from the XYZ staff, how would you rate the value of their services?

O	Very Poor Value for the Money
O	Poor Value for the Money
O	Neither Good nor Poor Value for the Money
O	Good Value for the Money
O	Very Good Value for the Money

41. Please consider all your experiences to date with XYZ. Using the 10-point scale below, indicate how satisfied you are with XYZ products and services.

O	1 Very Dissatisfied
O	2
O	3
O	4
O	5
O	6
O	7
O	8
O	9
O	10 Very Satisfied

42. Considering all of your expectations, do XYZ products and services fall short of or exceed your expectations?

O	1 Falls Short of Expectations
O	2
O	3
O	4
O	5
O	6
O	7
O	8
O	9
O	10 Exceeds Expectations

43. Imagine an ideal organization providing XYZ services. How well would XYZ compare with that ideal organization?

O	1 Not Close to Ideal
O	2
O	3
O	4
O	5
O	6
O	7
O	8
O	9
O	10 Very Close to Ideal

44. Use the following space to describe what XYZ is doing well.

45. Use the following space to describe what you would like to see XYZ change.