Form 010 2018 010 Q_PSCNewSecuirutyFeedbackSurvey_Web_Browse_2018
E-Government Website Customer Satisfaction Surveys
2018 010 Q_PSCNewSecuirutyFeedbackSurvey_Web_Browse_20180507.xlsx
2018 010 Q_PSCNewSecuirutyFeedbackSurvey_Web_Browse_20180507
OMB: 1090-0008
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1090-0008 can be found here:
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Model Questions
Custom Questions
Overview
Welcome and Thank You TextModel Questions
Custom Questions
Sheet 1: Welcome and Thank You Text
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The text you see here will appear at the top and bottom of your survey, examples below. | ||||
| Default text is included and you may modify this text as needed. | |||||
| Welcome and Thank You Text | |||||
| Welcome Text | Welcome Text - Tablet / Phone | ||||
Thank you for being a valuable PSC partner. Please take a few minutes to tell us how we are doing and where we can improve, to ensure you have the best experience possible. |
Thank you for taking our survey - and for helping us serve you better. We appreciate your input! | ||||
| Thank You Text | Thank You Text - Tablet / Phone | ||||
| Example Desktop | Example Mobile | ||||
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Sheet 2: Model Questions
| Model Name | PSC Security Feedback Survey |
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| Model ID | Underlined & Italicized: Re-order | |||||||
| Partitioned | No | Pink: Addition | ||||||
| Date | ||||||||
| Model Version | Custom | Blue: Reword | ||||||
| Label | Element Questions | Label | Satisfaction Questions | Label | Future Behaviors | |||
| CUSTOMER SATISFACTION | ||||||||
| MQ Label | ||||||||
| Satisfaction - Overall | What is your overall satisfaction with this service experience? (1=Very Dissatisfied, 10=Very Satisfied) | |||||||
| Satisfaction - Expectations | How well did this service experience meet your expectations? (1=Falls Short, 10=Exceeds) | |||||||
| Satisfaction - Ideal | How does this experience compare to an ideal service experience? (1=Not Very Close, 10=Close) | |||||||
Sheet 3: Custom Questions
| Model Name | PSC Security Feedback Survey |
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| Model ID | 0 | Underlined & Italicized: Re-order | |||||||
| Partitioned | No | Pink: Addition | |||||||
| Date | 1/1/2016 | Blue: Reword | |||||||
| QID | QUESTION META TAG | Skip From | Question Text | Answer Choices | Skip To | Required Y/N |
Type | Special Instructions | CQ Label |
| Where did you receive your enrollment services? | City | A | Y | Radio button, one-up vertical | Skip Logic Group* | Enrollment services | |||
| State | B | ||||||||
| A | In which City did you receive your enrollment services? | N | Text area, no char limit | Skip Logic Group* | OE_City Enrollment | ||||
| B | In which State did you receive your enrollment services? | Alabama | Y | Drop down, select one | Skip Logic Group* | Enrollment services_State | |||
| American Samoa | |||||||||
| Arizona | |||||||||
| Arkansas | |||||||||
| California | |||||||||
| Colorado | |||||||||
| Connecticut | |||||||||
| Delaware | |||||||||
| District of Columbia | |||||||||
| Florida | |||||||||
| Georgia | |||||||||
| Guam | |||||||||
| Hawaii | |||||||||
| Idaho | |||||||||
| Illinois | |||||||||
| Indiana | |||||||||
| Iowa | |||||||||
| Kansas | |||||||||
| Kentucky | |||||||||
| Louisiana | |||||||||
| Maine | |||||||||
| Maryland | |||||||||
| Massachusetts | |||||||||
| Michigan | |||||||||
| Minnesota | |||||||||
| Mississippi | |||||||||
| Missouri | |||||||||
| Montana | |||||||||
| Nebraska | |||||||||
| Nevada | |||||||||
| New Hampshire | |||||||||
| New Jersey | |||||||||
| New Mexico | |||||||||
| New York | |||||||||
| North Carolina | |||||||||
| North Dakota | |||||||||
| Northern Mariana Islands | |||||||||
| Ohio | |||||||||
| Oklahoma | |||||||||
| Oregon | |||||||||
| Pennsylvania | |||||||||
| Puerto Rico | |||||||||
| Rhode Island | |||||||||
| South Carolina | |||||||||
| South Dakota | |||||||||
| Tennessee | |||||||||
| Texas | |||||||||
| US Virgin Islands | |||||||||
| Utah | |||||||||
| Vermont | |||||||||
| Virginia | |||||||||
| Washington | |||||||||
| West Virginia | |||||||||
| Wisconsin | |||||||||
| Wyoming | |||||||||
| What type of appointment did you receive at your Badging Office on this visit? | PIV Card Insurance | Y | Radio button, one-up vertical | Type of appointment | |||||
| Enrollment | |||||||||
| External Card Binding | |||||||||
| ALT Card Issuance | |||||||||
| Certificate Update/Pin Reset | |||||||||
| Troubleshooting PIV Card | |||||||||
| Other | |||||||||
| Thinking only about today's specific visit, please rate your satisfaction of the following: Ability of staff to handle problem |
Poor = 1 | Y | Radio button, scale, no don't know | Handle problem | |||||
| 2 | |||||||||
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| 9 | |||||||||
| Excellent = 10 | |||||||||
| Clarity of information sent/emailed to you prior to your visit | Poor = 1 | Y | Radio button, scale, no don't know | Clarity of info | |||||
| 2 | |||||||||
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| Excellent = 10 | |||||||||
| Courtesy of staff | Poor = 1 | Y | Radio button, scale, no don't know | Courtesy | |||||
| 2 | |||||||||
| Breakpoint. Remove this line. | 3 | ||||||||
| 4 | |||||||||
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| Excellent = 10 | |||||||||
| Responsiveness of staff | Poor = 1 | Y | Radio button, scale, no don't know | Responsiveness | |||||
| 2 | |||||||||
| Breakpoint. Remove this line. | 3 | ||||||||
| 4 | |||||||||
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| Excellent = 10 | |||||||||
| Timeliness of service provided | Poor = 1 | Y | Radio button, scale, no don't know | Timeliness | |||||
| 2 | |||||||||
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| Excellent = 10 | |||||||||
| Environment friendliness | Poor = 1 | Y | Radio button, scale, no don't know | Environment_friendliness | |||||
| 2 | |||||||||
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| Excellent = 10 | |||||||||
| Environment tidiness | Poor = 1 | Y | Radio button, scale, no don't know | Environment_tidiness | |||||
| 2 | |||||||||
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| 9 | |||||||||
| Excellent = 10 | |||||||||
| Did this visit take care of all your enrollment needs? | Yes, I received everything I needed | Y | Radio button, one-up vertical | Skip Logic Group* | Met needs | ||||
| No, there are/were outstanding issues that still need(ed) to be resolved | A | ||||||||
| A | If not resolved today, were you given instructions/advised on next steps in the process? | Yes | Y | Radio button, one-up vertical | Skip Logic Group* | Met needs_NO | |||
| No | |||||||||
| Not applicable | |||||||||
| Do not remember | |||||||||
| How long was today’s enrollment visit? | Shorter than 15 minutes | Y | Radio button, one-up vertical | Enrollment length | |||||
| Between 15-30 minutes | |||||||||
| Longer than 30 minutes | |||||||||
| Do not remember | |||||||||
| What can we do to make the next customer’s experience better? | N | Text field, <100 char | OE_Improvement |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |
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