CWT IT Consumers Satisfaction Survey_1

CWT IT Consumers Satisfaction Survey

OMB No. 2900-0770
Estimated Burden: 10 minutes

Expiration Date: 08/31/2017

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 10 minutes. This includes the time it will take to follow instructions, gather the necessary facts and respond to questions asked. Customer satisfaction is used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this telephone/mail survey will lead to improvements in the quality of service delivery by helping to achieve services. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled.

Incentive Therapy Program

VA Medical Center

Danville IL

Date: ______/______/______

Please complete this brief questionnaire. The information will provide feedback that will assist in planning and delivery of future services. Please refer only to those vocational rehabilitation experiences you had with the Therapeutic Supported Employment Services Program (TSES) staff at the Danville VA Medical Center. All information provided will be kept private. Thank you for your time and assistance.

The Scale is as follows

SD = Strongly Disagree D = Disagree N = Neutral A = Agree SA = Strongly Agree

SD D N A SA

1. The TSES staff treat me with respect and courtesy [ ] [ ] [ ] [ ] [ ]

2. I know Job Club is available to assist me in keeping/finding a job. [ ] [ ] [ ] [ ] [ ]

3. The TSES staff appears to listen and understand my situation. [ ] [ ] [ ] [ ] [ ]

4. I am involved in making choices about my goals and services. [ ] [ ] [ ] [ ] [ ]

5. Job selection and placement is done fairly. [ ] [ ] [ ] [ ] [ ]

6. The Computer Lab is available to me when needed. [ ] [ ] [ ] [ ] [ ]

7. I would recommend the services of the TSES staff to other veterans. [ ] [ ] [ ] [ ] [ ]

8. My appointments are kept in a timely manner. [ ] [ ] [ ] [ ] [ ]

9. My current rehabilitation needs are being met. [ ] [ ] [ ] [ ] [ ]

10. Internet access is an important service provided by the Computer Lab. [ ] [ ] [ ] [ ] [ ]

11. My current training/education needs are being addressed or resolved. [ ] [ ] [ ] [ ] [ ]

12. My IT work assignment has been a positive experience. [ ] [ ] [ ] [ ] [ ]

13. My IT site supervisor treats me with respect and courtesy. [ ] [ ] [ ] [ ] [ ]

14. I have the right equipment and training to do my job right and [ ] [ ] [ ] [ ] [ ]

safely.

Please tell us how you feel about the following statements:

15. I got the service I needed. [ ] [ ] [ ] [ ] [ ]

16. It was easy to get the service I needed. [ ] [ ] [ ] [ ] [ ]

17. I felt like a valued customer. [ ] [ ] [ ] [ ] [ ]

18. I trust VA to fulfill our country’s commitment to Veterans. [ ] [ ] [ ] [ ] [ ]

Please offer any comments or suggestions that may be helpful in improving VRT services to you and others in the future. These comments are very helpful in modifying provision of services to more effectively meet veterans’ needs. Please use the space below to add further comments or suggestions. Let us know what we are doing well; what can be done better; and what you would like to see us do differently.

COMMENTS: