VE Access Survey Questions

OMB No. 2900-0770

Estimated Burden: 1 minute

OMB Expiration Date: XX/XX/XXXX

Veterans Experience Access Survey Questions

Scheduling Appointment

The Paperwork Reduction Act of 1995: 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 one (1) minute. This includes the time it will take to follow instructions, gather the necessary facts and respond to questions asked. Customer satisfaction with scheduling appointments is used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this e-mail survey will lead to improvements in the process of scheduling appointments. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled.

Veterans will be asked to respond to the following two questions via e-mail:

Draft Questions will be rated on a five point Likert scale:

DRAFT MESSAGE BELOW:

Dear INSERT NAME

The Department of Veterans Affairs is reorganizing to put your needs, expectations and interests front and center; we are calling this powerful new effort the MyVA transformation. Our goal is to consistently deliver to you easy and effective experiences where you feel valued.

To help us align our services with your needs and expectations, I’d like to personally invite you to share your recent VA experience with us related to scheduling your most recent appointment. Your feedback will help us focus our improvements on what is important to you.

We estimate this survey will take less than a minute of your time. Please submit your feedback to us by INSERT DATE.

1. VA scheduled my appointment for a time that worked for me.

• Strongly Agree

• Agree

• Neither Agree or Disagree

• Disagree

• Strongly Disagree

2. When scheduling my appointment, I was treated with courtesy and respect.

• 

  DRAFT

  Strongly Agree

• Agree

• Neither Agree or Disagree

• Disagree

• Strongly Disagree