Benefits.gov Customer Satisfaction Survey and Comment Card

Benefits.gov Program

Customer Satisfaction Survey powered by iPerceptions

Benefits.gov Survey:

1. Device (invisible to respondents; automatically answered)

   1. Desktop

   2. Mobile

   3. Tablet

2. Source (invisible to respondents; automatically answered)

   1. Website b. Receipt c. CMS/CRM d. Mobile Website e. QR Code

f. SMS g. Social Media h. Email campaign i. Video game j. Offline

k. Link l. Navigation System m. Embedded n. API

3. How would you rate your overall experience on the website today?

   1. Choice between 0 and 10 (0 being very bad, 10 being outstanding)

4. Which of the following describes the primary purpose of your visit?

   1. To find more information about a specific program

   2. I need help, but do not know what is available

   3. I want to find out how to apply for a specific benefit

   4. I am curious about what programs are available

   5. Other, please specify

5. Where you able to complete the purpose of your visit today?

   1. Yes

   2. No

6. What do you value most about the Benefits.gov website?

   1. Open-ended response

7. Please tell us why you were not able to complete the purpose of your visit today.

   1. Open-ended response based on answer to Q5

8. Based on your experience today, how likely are you to recommend Benefits.gov to friends and relatives?

   1. Choice between 0 and 10 (0 being very bad, 10 being outstanding)

9. Which of the following describes how often you visit this website?

   1. This is my first visit ever

   2. First visit in the last 3 months

   3. 2 – 5 visits in the last 3 months

   4. 6+ visits in the last 3 months

10. How did you arrive at the website today?

    1. Clicked on a link on a search engine (e.g. Google, Yahoo!, etc)

    2. Clicked on a link with an email

    3. Bookmark / favorites

    4. Typed the URL into a browser

    5. Clicked on an advertisement

    6. From a link on a blog, forum, or social network

    7. Clicked on a link on another site

    8. From a link sent to me by a friend

    9. Other

11. Which of the following best describes your role in visiting today?

    1. Agency Representative, Benefit Advocate/Caseworker

    2. Disabled

    3. Injured/Sick

    4. Low Income

    5. Military (Active or Retired) or military dependent

    6. Parent/Caregiver

    7. Student

    8. Senior/Retiree

    9. Unemployed

    10. Native American/Alaska Native/American Indian

    11. Other, please specify:

12. What is your gender?

    1. Female

    2. Male

    3. I prefer not to answer this question

13. What is your age group?

    1. Under 18

    2. 18-24

    3. 25-34

    4. 35-44

    5. 45-54

    6. 55-64

    7. 65+

    8. I prefer not to answer this question

14. What could we add to this website to make it better?

    1. Open-ended response

15. Would you like to have the option to apply for benefits online through Benefits.gov?

    1. Yes

    2. No