Form 10-1500199(WS) MySurvey

InfoApp

OMB Control No.: 2900-0770
Estimate Burden: 30 minutes
Expiration Date: 08/31/2017

Welcome to My Survey

The Department of Veterans Affairs is developing a mobile application that is intended to provide
Veterans, caregivers and family members a repository of information about VA facilities. Some of
the proposed features include but are not limited to VA facility's map, phone numbers, shuttle
service information and frequently asked questions (FAQs).
The design team for the VA InfoApp would like your feedback on what features should be prioritized
and what if any features that are not currently planned should also be included with the application
and why.
The following questions will ask you to rate the value of certain proposed features and some of
their characteristics. Just answer each question from your gut, there are no wrong answers. Please
make use of the comment boxes to add additional comments and suggestions. You will also be
presented with an opportunity to suggest and rate any features that you would like to see that were
not mentioned.

InfoApp
Veterans Affairs Information Application (VA InfoApp)

The following list of features represent what is intended for inclusion in the VA InfoApp. Please rate
each item based on how valuable you feel the named feature would be to you. Please do so a scale
from Extremely Valuable to Not Valuable.

VA Form 10-1500199 (WS)

* 1. Please rate how valuable each the following features of the VA InfoApp.
Extremely Valuable

Valuable

Somewhat Valuable

Not Valuable

Not Applicable (N/A)

Facilities Map
VA Phone Directory
Shuttle Service
Information/Availability
Frequently Asked
Questions (FAQ)
Individual Facility Pages
(specific facilities'
information)
Text to Speech
Instructions
Common VA branded
look and feel (i.e. looks
like other VA
apps/websites)
Feedback Forms (to
provide feedback on the
app from within the app)
Search Capabilities
Comments or suggestions:

InfoApp

For this next set of questions I would like you to rate the value of characteristics of the features in the first
question.

* 2. Please rate the value of each the following proposed characteristics of the "Facilities Map."
Extremely Valuable
Select from a list of
states to get to a list of
facilities.
Zoom-in on a map to go
to a VA Medical Center.
Zip Code Search
GPS Location of VA
Facilities
Directions to VA facilities
Ability to search for and
display information
about VA facilities in a
map view.
Ability to automatically
locate facilities within a
user defines area.
Satellite View of Map

InfoApp

Valuable

Somewhat Valuable

Not Valuable

Not Applicable (N/A)

* 3. Please rate the value of each the following proposed characteristics of the "VA Phone Directory."
Extremely Valuable
Dial in app capabilities
(dials when users
selects number).
Provide access to VA
phone directory.
Staff directory with
search for specialists.
Provide the ability to
display direct phone
numbers for clinics and
departments such as
primary care, pharmacy,
lab, etc.
Satellite View of Map
Comments or suggestions:

InfoApp

Valuable

Somewhat Valuable

Not Valuable

Not Applicable (N/A)

* 4. Please rate the value of each the following proposed characteristics of the "Shuttle Service Information."
Extremely Valuable
Phone number listed so
that Veterans can
request transportation to
and from VA facilities on
their phones.
Information on shuttle
services to and from VA
facilities (e.g.,
availability of
transportation, maps to
and from shuttle
services).
Information on shuttle
services to and from VA
facilities.
Information on available
parking at VA facilities as
well as location, price
and type of parking
available.
Comments or suggestions:

InfoApp

Valuable

Somewhat Valuable

Not Valuable

Not Applicable (N/A)

* 5. Please rate the value of each the following proposed characteristics of the "Individual Facility Pages."
Extremely Valuable
Information on hours
various services within
VA are open/available.
Ability to display "more"
resource specific
department and clinic
data elements:
department and clinic
direct phone extensions,
hours of operation, titles,
names, email addresses.
Advertisements for
classes
Information about
events
Contact information
updates
Comments or suggestions:

InfoApp

Valuable

Somewhat Valuable

Not Applicable (N/A)

* 6. Please rate the value of each the following proposed characteristics of the "Feedback Forms."
Extremely Valuable

Valuable

Somewhat Valuable

Not Valuable

Evaluation form for
users to provide
feedback on current app
functionality.
Provide the ability for
users to provide
feedback to VA, e.g. to
notify VA about incorrect
resource data.
Comments or suggestions:

InfoApp

7. Please suggest any feature you would like to see included in the VA InfoApp.
[FIRST] Suggestion
[SECOND] Suggestion
[THIRD] Suggestion
[FORTH] Suggestion
[FIFTH] Suggestion

Not Applicable (N/A)

8. Please rate the value of your suggestion(s) if applicable.
Extremely Valuable

Valuable

[FIRST] Suggestion
[SECOND] Suggestion
[THIRD] Suggestion
[FORTH] Suggestion
[FIFTH] Suggestion
Other (please specify)

9. What would make you more likely to use an InfoApp?

* 10. Do you have any other comments, questions or concerns?
Yes
No
Please enter comments, questions or concerns.

Somewhat Valuable

Not Valuable