ABA Complainant Customer Satisfaction Survey

OMB Control No. 3014-0011
OMB Expiration Date: 1/31/2018
Estimated Burden: 3 Minutes

U.S. Access Board Customer Satisfaction Survey
The Access Board wants to know about your experience with filing and resolving your recent complaint under the
Architectural Barriers Act. Your responses will help us provide better customer service. We would greatly
appreciate it if you could fill out this short questionnaire.
Please rate each statement on a scale of 1 (strongly agree) to 5 (strongly disagree). Circle your response.
Neither
Agree nor
Disagree

Strongly
Agree
1. The Access Board staff was helpful and
courteous in responding to my concerns or
questions.
2. The Access Board staff kept me informed of
the status of my complaint.
3. The Access Board staff responded to my
concerns or questions in a timely manner.
4. The Access Board staff was knowledgeable
about my complaint and related accessibility
issues.
5. I was satisfied with the efforts made to address
the accessibility issues I raised in my
complaint.
6. The amount of time taken to address my
complaint was reasonable.
7. I was satisfied with the outcome or result I saw
in the facility about which I filed a complaint.

Strongly
Disagree

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

Please answer the following questions.
8. Was the accessibility barrier about which you filed a complaint
eventually removed or corrected?

(circle your response)

Yes

No

9. Was this the first complaint you had filed with the Access Board?

(circle your response)

Yes

No

10. How did you learn about the Access Board?
___ Independent Living Center
___ Internet

(place an X next to your response)

___ Client Assistance Program
___ Newspaper

___ Referred by a Federal or State Agency
___ Other; please explain: _____________

11. Please give us any suggestions or comments you may have regarding how we can improve our efforts to
respond to and resolve accessibility complaints. Please feel free to use the back page or attach an additional
page._________________________________________________________________________________

_____________________________________________________________________________________
_____________________________________________________________________________________
OPTIONAL: If you wish, please provide your complaint number:
Complaint Number: ______________

Paperwork Reduction Act Notice: Pursuant to the Paperwork Reduction Act of 1995, and its implementing
regulations at 5 CFR 1320.8(b)(3), the United States Access Board may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a valid OMB Control Number.