Cooperative Studies Program

Cooperative Studies Program (CSP) Study Site Survey

OMB No. 2900-0770
Estimated Burden: 10 minutes

Expiration Date: 9/30/2020

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 quality improvement within our services. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled.

In an effort to continue to improve customer service, CSP is conducting a survey to find our strengths and weaknesses. Please answer the following questions. All surveys will remain anonymous.

1. What is your role in the CSP study (optional)?

The following questions refer to your experience interacting with your CSPCC or ERIC (for this survey - Center)

2. How often are you in contact with your Center?

Multiple times a week	Once a week	1 – 3 times a month	Less than once a month
1	2	3	4

3. Which Center is your study Coordinated from? (if on multiple studies, circle more than 1 if necessary)

Boston ERIC	Hines CSPCC	Palo Alto CSPCC	Perry Point CSPCC	Seattle ERIC	West Haven CSPCC
1	2	3	4	5

4. My Center provides me with the materials and information needed to meet the requirements of the study.

Does not meet needs	Needs Improvement	Meets needs
1	2	3

5. Center staff provides me with knowledgeable answers to questions about the study.

Strongly disagree	Disagree	Neutral	Agree	Strongly Agree	N/A
1	2	3	4	5

6. Center staff returns my calls/emails in a timely manner.

Strongly disagree	Disagree	Neutral	Agree	Strongly Agree	N/A
1	2	3	4	5

7. Center staff is courteous and professional.

Strongly disagree	Disagree	Neutral	Agree	Strongly Agree	N/A
1	2	3	4	5

8. The Operations Manual and Forms provided are clear, accurate and easy to follow.

Strongly disagree	Disagree	Neutral	Agree	Strongly Agree	N/A
1	2	3	4	5

9. Overall, how would you rate your Center’s customer service?

Poor	Fair	Good	Very Good	Excellent	N/A
1	2	3	4	5

10. How would you rate your Center’s service as it relates to meeting planning?

Poor	Fair	Good	Very Good	Excellent	N/A
1	2	3	4	5

11. How would you rate your Center’s service as it relates to regulatory support?

Poor	Fair	Good	Very Good	Excellent	N/A
1	2	3	4	5

12. How would you rate your Center’s service as it relates to responding to study issues?

Poor	Fair	Good	Very Good	Excellent	N/A
1	2	3	4	5

13. How would you rate your Center’s service as it relates to technical support?

Poor	Fair	Good	Very Good	Excellent	N/A
1	2	3	4	5

14. Where could your Center be more helpful?