Form FEMA Form 519-0-57 FEMA Form 519-0-57 Interactive Voice Response Post Call Survey

D raft: Interactive Voice Response Post Call Survey

OMB Control Number 1660-0130

Expiration Date

PAPERWORK BURDEN DISCLOSURE NOTICE

FEMA Form 519-0-57 (Interactive Voice Response post-call survey)

Public reporting burden for this data collection is estimated to average 2.5 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. This collection of information is voluntary. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW., Washington, DC 20472-3100, Paperwork Reduction Project (1660-NEW) NOTE: Do not send your completed form to this address.

PRIVACY ACT STATEMENT

AUTHORITY: Government Performance and Results Act of 1993 (Pub. L. 103-62), as amended, and the GPRA Modernization Act of 2010 (Pub. L. 111-352); Executive Order (EO) 12862, “Setting Customer Service Standards”; and its March 23, 1995 Memorandum addendum, “Improving Customer Service”; Executive Order 13411 “Improving Assistance for Disaster Victims”; Executive Order 13571 “Streamlining Service Delivery and Improving Customer Service”; and the related June 13, 2011 Memorandum “Implementing Executive Order 13571 on Streamlining Service Delivery and Improving Customer Service.”

PRINCIPAL PURPOSE(S): DHS/FEMA collects this information to measure Individual Assistance applicants’ customer satisfaction with FEMA services.

ROUTINE USE(S): This information is used for the principal purpose noted above and will not be shared outside of DHS/FEMA, except as allowed under the routine uses published in System of Records Notice DHS/FEMA-008 - Disaster Recovery Assistance Files, 78 FR 25282 (April 30, 2013), or as required by law. The Department's system of records notices can be found on the Department's website at http://www.dhs.gov/system-records-notices-sorns.

DISCLOSURE: The disclosure of information on this form is strictly voluntary and will assist FEMA is making improvements to its Individual Assistance program; failure to provide the information requested will not impact an individual’s ability to qualify for or receive FEMA Individual Assistance.

QUESTIONNAIRE

English Version

Process: Inbound call received at FEMA’s toll free call center number. Standard IVR routing applies to identify preferred language (English or Spanish). After that selection, standard instructions and privacy information is provided. The caller is then able to select the unit/group being called (i.e. Registration Intake or Helpline). After that selection the caller hears the following:

Standard Invitation – “Your feedback is extremely important to us. Would you volunteer to take 2 to 3 minutes to answer a few questions after your call? Press 1 for Yes or 2 for No.”

If No Standard Opt-Out “We will connect your call. Thank you.”

If Yes Standard Opt-In “Thank you. Please remain on the line after you complete your call.

When the call with the agent is complete, callers who responded Yes to Opt-In to the survey will hear:

Welcome

“Thank you for offering to take the survey. These questions comply with the Privacy Act of 1974 and have been approved by the Office of Management and Budget under number ____. Your answers will not affect the outcome of your FEMA assistance.”

“Please use your telephone keypad to answer questions. If you would like to skip a question, select the pound sign. To hear the question again, just wait a few seconds and it will repeat. ”

Survey Questions

“Using a scale of 1 to 5, with 1 being Not at all Satisfied and 5 being Very Satisfied, how satisfied were you with how easy it was to reach FEMA today?

“Using a scale of 1 to 5, with 1 being Poor and 5 being Excellent, how would you rate the information provided to you today on being easy to understand?”

“Again using a scale of 1 to 5, with 1 being Poor and 5 being Excellent, how would you rate today’s information on answering your questions?”

“Using the same scale of 1 to 5, with 1 being Poor and 5 being Excellent, how would you rate the courtesy of the FEMA representative who assisted you today?”

“Based on a scale of 1 to 5, with 1 being Poor and 5 being Excellent, how would you rate the overall customer service provided to you today?”

Finish - “Thank you for your time and for helping us improve our service. Goodbye.”

FEMA Form 519-0-57