Form FEMA Form 007-0-6 FEMA Form 007-0-6 Casework Survey

Casework Survey

OMB Control Number 1660-0036

Expiration Date 02/28/2014

PAPERWORK BURDEN DISCLOSURE NOTICE: Public reporting burden for this survey is estimated to average 6 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting the survey. You are not required to respond to this collection of information unless it displays a valid OMB control number near the title of the electronic collection instrument, or for on-line applications, on the first screen viewed by the respondents. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (1660-0036) NOTE: Do not send your completed form to this address.

The following survey is voluntary.

PRIVACY ACT STATEMENT

AUTHORITY: Government Performance and Results Act (GPRA), 5 U.S.C. Ch. 3 as amended and the GPRA of 2010 (P.L. 111-352); Executive Order (EO) 12862, “Setting Customer Service Standards;” and its March 23, 1995 Memorandum addendum, “Improving Customer Service;” Executive Order 13411 “Improving Assistance for Disaster Victims;” Executive Order 13571 “Streamlining Service Delivery and Improving Customer Service;” and its June 13, 2011 Memorandum “Implementing Executive Order 13571 on Streamlining Service Delivery and Improving Customer Service.”

PRINCIPAL PURPOSE(S): DHS/FEMA collects this information to measure Individual Assistance customers’ satisfaction with FEMA services.

ROUTINE USE(S): This information is used for the principal purpose(s) noted above and will not be shared outside of DHS/FEMA, except as allowed under DHS/FEMA-008 - Disaster Recovery Assistance Files (April 30, 2013, 78 FR 25282), or as required by law.

DISCLOSURE: The disclosure of information on this form is strictly voluntary and will assist FEMA is making improvements to its Individual Assistance program; failure to provide the information requested will not impact the provision of FEMA Individual Assistance to qualified entities.

QUESTIONS

Introduction

Hello, I’m calling from FEMA, the Federal Emergency Management Agency. My name is ___. My ID # is _________. May I please speak with (Applicant) or the person who received a phone call from FEMA Representative (Agent) on (Call Date)?

• Yes

• No

If no: What would be a better time to call back? Thank you for your time and have a good day/evening.

If yes: We're looking for ways to improve the quality of our service and your opinion is very important to us. Do you remember speaking with (Agent) when he/she called you about your application for FEMA disaster assistance?

• Yes

• No

If no: Thank you for your time and have a good day/evening.

If yes: Would you volunteer to take 3-7 minutes to answer some questions?

• Yes

• No

If no: What would be a better time to call back? Thank you for your time and have a good day/evening.

If yes: Thank you. These questions comply with the Privacy Act of 1974 and have been approved by the Office of Management and Budget under number 1660-0036. Your answers will not affect the outcome of your application for FEMA assistance. This call may be monitored and/or recorded for quality assurance.

Let's start with questions related only to the telephone call with [Agent] who called you on [Call Date].

1. Using a rating scale of Excellent, Good, Satisfactory, Below Average or Poor, how would you rate (Agent) on showing an interest in helping you?

If response = Below Average or Poor go to1a else go to 2.

1a. What made you feel he/she was not interested in helping?

• Didn’t Answer Question(s)

• Didn’t Listen

• Didn’t make Me Eligible

• Minimized my losses

• No Empathy

• Rushed Call

• Other

2. How would you rate him/her on being courteous?

• Excellent

• Good

• Satisfactory

• Below Average

• Poor

If response = Below Average or Poor go to 2a otherwise go to 3.

2a. In what way was he/she not courteous?

• Accusatory

• Agent wasn’t Knowledgeable

• Condescending

• Didn’t Answer Questions

• Impatient

• Interrupted

• No Empathy

• Rude

• Tone of voice

• Other

Now thinking about the information [Agent] provided during the call,

3. How would you rate him/her on explaining information so it was easy to understand?

• Excellent

• Good

• Satisfactory

• Below Average

• Poor

If response = Below Average or Poor go to 3a, if Excellent go to 3b else go to 4.

3a. What did he/she do that made it difficult to understand?

• Agent Wasn’t Knowledgeable

• Didn’t Answer Questions

• Inconsistent Information

• Jargon/Terminology

• No Empathy

• Speech Unclear

• Talked too Fast

• Too Complicated

• Rude

• Other

3b. What specifically did he/she do to help you understand the information?

• Answered Questions

• Asked if I Understood

• Explained Details

• Patient

• Repeated Information

• Used Easy to Understand Terminology

• Other

4. How would you rate him/her on letting you know what you needed to do next?

• Excellent

• Good

• Satisfactory

• Below Average

• Poor

If response = Below Average or Poor go to 4a else go to 5.

4a. In what way was he/she [Below Average/Poor] in letting you know what you needed to do next?

• Agent wasn’t Knowledgeable

• Didn’t answer Questions

• Next Steps not Given

• Rushed/No time to Write information

• Too Confusing

• Too much Information

• Other

5. Overall, would you say the level of customer service provided by (Agent) was Excellent, Good, Satisfactory, Below Average or Poor?

If response = Satisfactory Below Average or Poor go to 5a else go to 6.

5a. What specifically could he/she have done better?

• Be More Accurate

• Be More Clear

• Be More Caring/Empathetic

• Have more Patience

• Provide More Details

• Use Plain Language

• Other

6. Your opinion is very valuable to us. May we call at a later date to ask some additional questions?

• Yes

• No

Closing

Thank you for your time. Have a good day/evening.

.

FEMA Form 007-0-6 9