Internet Registration Electronic Survey
OMB Control Number 1660-0036
Expiration Date _______
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 in 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
Thanks for visiting the DisasterAssistance.gov web site. Please take 4 - 6 minutes to share your opinions on what we are doing well and where improvements are needed. Your voluntary feedback will help us to better serve disaster survivors.
Did you personally complete the online application for FEMA Disaster Assistance?
Yes
No
If no: Thank you for your time. End the questionnaire by closing your browser.
If yes:.
1. Which of the following websites did you access to apply for FEMA assistance?
DisasterAssistance.gov
FEMA.gov
Another Federal Government website
Another State Government website
A Non-Government website
Don't Remember
(If response = DisasterAssistance.gov or FEMA.gov go to Q1a else go to Q2.)
1a. How did you find out about that the [DisasterAssistance.gov/FEMA.gov] website?
Community Group (club, church, school, etc.)
Disaster Worker (FEMA, Red Cross, Local Government, etc.)
Flyers, Signs, Billboards, Posters, etc.
Internet searches (Google, Bing, etc.)
Newspaper
Prior Experience
Radio
Service Provider (Insurance, water, gas, phone, etc.)
Social Media (Facebook, Twitter, etc.)
Text, Phone, Email Alerts (reverse 911, robo call, RSS Feed, etc.)
Television
Word of Mouth (friend, family, neighbor, employer, landlord, etc.)
Don’t Remember
Other (Please Explain in 500 characters or less)
The website provided a variety of options such as Apply Online, Check your Status or Find Assistance
2. Did you complete the Anonymous Questionnaire to find personalized assistance?
Yes
No
Don't Remember
(If response = Yes go to Q2a displays else go to Q3a.)
2a. This series of questions relates only to the online anonymous questionnaire you used to find other Forms of Assistance. How would you rate the questions on being easy to understand?
Extremely Easy
Very Easy
Easy
Not Very Easy
Not At All Easy
No Opinion
2b. After completing the online anonymous questionnaire, you may have received information about other agencies. How helpful was that information?
Extremely Helpful
Very Helpful
Helpful
Not Very Helpful
Not At All Helpful
No Opinion
(If response = Not Very Helpful or Not At All Helpful go to Q2c else go to Q3a.)
2c. How could the information about other agencies have been more helpful?
Make less complicated/confusing
More concise information
More detailed information
Personalized information specific to my situation (Please Explain in 500 characters of less.)
Complete & accurate contact phone number
Complete & accurate web address/link
Other (Please Explain in 500 characters or less)
The website also provided options to browse information by Category or by Federal Agency.
3a. How helpful was it to browse by Category?
Extremely Helpful
Very Helpful
Helpful
Not Very Helpful
Not At All Helpful
Did not use this Method
No Opinion
3b. How helpful was it to browse by Agency?
Extremely Helpful
Very Helpful
Helpful
Not Very Helpful
Not At All Helpful
Did not use this Method
No Opinion
4. Overall, how would you rate this website for obtaining disaster assistance information?
Excellent
Good
Satisfactory
Below Average
Poor
No Opinion
(If response = Below Average or Poor go to Q4a else go to Q5.)
4a. The prior question asked you to rate the website for obtaining disaster assistance information. Which of the following reasons influenced your rating?
Did not find what I needed (Please Explain in 500 characters or less.)
Phone numbers not provided/inaccurate
Questions too complicated/hard to understand
Referrals hard to understand
Referrals too lengthy
Response options too complicated/hard to understand
Screen navigation difficult
Technical problems
Web address or link not provided/inaccurate
Other (Please Explain in 500 characters or less.)
For the next questions, please think only about your experience in completing the online application for FEMA disaster assistance.
5. Overall, how would you rate that experience?
Excellent
Good
Satisfactory
Below Average
Poor
No Opinion
(If Below Average or Poor go to go to Q5a else go to 6.)
5a. Using the below list, please identify the reasons why the online application for FEMA disaster assistance experience was less than satisfactory.
Could not edit or make comments
Help Page information hard to understand
Instructions hard to understand (Please Explain in 500 characters or less.)
Not applicable to my situation
Screen navigation was difficult
Technical problems
Took too long to complete application
Type of assistance not clear (Please Explain in 500 characters or less.)
Other (Please Explain in 500 characters or less.)
6. Each screen included a "Help for this page" button to assist you in filling out your application. Would you say the help information was…
Excellent
Good
Satisfactory
Below Average
Poor
Did not use
(If response = Below Average or Poor go to Q6a else go to Q7.)
6a. In what way was the “Help for this page” information [Below Average/Poor]?
Did not understand the terms used
Information was too complicated (Please Explain in 500 characters or less.)
Not enough information/did not answer question (Please Explain in 500 characters or less.)
Technical difficulties
Other (Please Explain in 500 characters or less.)
7. After completing your application, information was displayed about other agencies or organizations that may be able to assist you. How helpful was that information?
Extremely Helpful
Very Helpful
Helpful
Not Very Helpful
Not At All Helpful
Did not use
No Opinion
(If response = Not Very Helpful or Not At All Helpful go to Q7a else go to Q8.)
7a. Please indicate why you found the agency and organization information to be less than helpful.
Agency contact information not complete/accurate or could not help
Descriptions of agency services were hard to understand/confusing (Please Explain in 500 characters or less.)
No agency found for assistance needed (Please Explain in 500 characters or less.)
Not enough information
Screen navigation difficult
Too much information (Please Explain in 500 characters or less.)
8. Did you call the website’s Technical Support toll free number for assistance with technical problems?
Yes
No
Do not remember
(If response = yes go to Q8a else go to Q9.)
8a. Thinking only about your communications with Technical Support, how would you rate the service you received?
Excellent
Good
Satisfactory
Below Average
Poor
No Opinion
(If response = Below Average or Poor go to Q8b else go to Q9.)
8b. In what way was the service from Technical Support [Below Average/Poor]?
Technical Rep did not answer question (Please Explain in 500 characters or less.)
Technical Rep gave incorrect information (Please Explain in 500 characters or less.)
Technical Rep provided poor customer service
Took too long or could not get through to Technical Helpdesk
Other (Please Explain in 500 characters or less.)
9. In the future, should you need disaster assistance, how likely are you to use the online application?
Definitely use
Probably use
Might or Might Not use
Probably would Not use
Definitely would Not use
No Opinion
(If response = Probably would Not use or Definitely would Not use go to Q9a else go to Q10.)
9a. What changes are needed to increase the likelihood of you using the online application in the future? (Please Explain in 500 characters or less)
10. Would you recommend the DisasterAssistance.gov site to a friend or family member?
Yes
No
Do Not Know
11. Your opinion is very valuable to us. May we contact you at a later date for additional feedback?
Yes
No
Thank you for your time.
FEMA Form 007-0-23
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | BACKGROUND |
| Author | TxNPSC |
| File Modified | 0000-00-00 |
| File Created | 2021-01-28 |