Feedback USA Button

OMB 2900-XXXX
Estimated Burden 3 minutes

Expiration Date: XX/XX/XXXX

Feedback USA Button
(Pilot)

Customer Satisfaction Survey Question

OMB 2900-0770

Respondent Burden: 4 minutes

Expiration Date: 08/31/2017

This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor, and you are not required to respond to a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who complete this survey will average 4 minutes. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. Customer satisfaction surveys are used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this survey will lead to improvement in the quality of service delivery by helping to shape the direction and focus of specific programs or services. Completion of this form is voluntary and failure to respond will have no impact on benefits to which you may be entitled.

OMB Control No. 2900-0770

Respondent Burden: 4 minutes

Expiration Date: 08/31/2017

Feedback USA Button Pilot

The question(s) for the Department of Veterans Affairs, Veterans Benefits Administration

Customers will have the option of answering via four color-coded buttons with faces ranging from very unhappy to very happy. We are rotating several questions to possibly garner feedback; however, we will ask only one customer satisfaction survey question via a kiosk. Under the pilot for Feedback USA all questions will be rotated on a 90 day period.

• How did we do today?

• How would you rate your experience today?

• How would you rate the quality of service you received?

  • F/u – What can we do to make it better (free form)

In addition, VBA will test the agency priority questions as noted below.

• I trust VA to fulfill our country’s commitment to veterans.

• I got the service I needed.

• It was easy to get what I needed.

• I felt like a valued customer.