2019 250 SSA Field Office Survey_12.19.19_Final

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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

Thank You Text
Thank you for taking our survey - and for helping us serve you better.
Please note you will not receive a response from us based on your survey
comments. If you would like us to contact you about your feedback, please visit
the Contact Us section of our website.

Example Desktop

ForeSee Results - Confidential and Proprietary

Model Name
Model ID
Partitioned
Date
Model Version

SSA Field Office
QpUwMkFBwwF9tsMB5NtdQQ4C
No

Red & Strike-Through: Delete
Underlined & Italicized: Re-order
Pink: Addition
Blue: Reword

11/5/2019
Custom

Label

Satisfaction Questions

Label

Satisfaction
1 Satisfaction - Overall What is your overall satisfaction with this Social Security office visit?
(1=Very Dissatisfied, 10=Very Satisfied)

Accessibility 5
Convenience

Element Questions
Accessibility
(1=Poor, 10=Excellent, Don't Know)
Please rate your experience receiving customer service at the Social
Security office in the following areas:

How well did your Social Security office visit meet your expectations?
(1=Fell Short, 10=Exceeded)

6 Accessibility - Easy
Connection

The ease of meeting with a representative

3 Satisfaction - Ideal

How well did your Social Security office visit compare to an ideal customer
service experience?
(1=Not Very Close, 10=Very Close)

7 Accessibility - Wait
Time

Amount of time spent waiting for a representative

Recommend (NPS)
(1=Very Unlikely, 10=Very Likely)
How likely are you to recommend this Social Security office visit
experience to someone else?

Future Behaviors
Visit Again (1=Very Unlikely, 10=Very Likely)

15 Visit Again

How likely are you to visit this office again for your Social Security
Administration service needs in the future?

The convenience of receiving customer service at the Social Security
office relative to the telephone or website.

2 Satisfaction Expectations

4 Recommend

Label

Service Representative
(1=Poor, 10=Excellent, Don't Know)
Please rate the representative who assisted you in the following areas:
8

Representative Understanding

9 Representative Empathy
10 Representative Knowledge
11 Representative Authority

Understanding of your issue or request
Recognition of the importance of your issue or request
Level of knowledge regarding your issue or request
Level of authority to resolve your issue or request on their own
Service Resolution

Service Resolution - Please rate the response provided to your request or question in the
Complete
following areas:
The extent to which your issue or request was resolved
12
(1=Not Resolved at all, 10=Completely Resolved, Don't Know)
13 Service Resolution - Thoroughness of any information provided
Thoroughness
(1=Poor, 10=Excellent, Don't Know)
14 Service Resolution - Efficiency of the service provided
Efficiency
(1=Poor, 10=Excellent, Don't Know)

ForeSee Results - Confidential and Proprietary

SSA Field Office
QpUwMkFBwwF9tsMB5NtdQQ4C
No
11.27.19
Skip
From

Red & Strike-Through: Delete
Underlined & Italicized: Re-order
Pink: Addition
Blue: Reword
Question Text

Please indicate your level of agreement with the following
statements about your interaction today:
I am satisfied with the service I received from the Social
Security Administration.

Answer Choices

Skip To

1=Strongly Disagree

Required
Type
Y/N
Y
Radio button, scale, no
don't know

Special Instructions

CQ Label
A11-Satisfied

2
3
4
Strongly Agree=5
This interaction increased my confidence in the Social Security 1=Strongly Disagree
Administration.

Y

Radio button, scale, no
don't know

A11-Trust

Y

Radio button, scale, no
don't know

A11-Quality

Y

Radio button, scale, no
don't know

A11-Ease

Y

Radio button, scale, no
don't know

A11-Speed

Y

Radio button, scale, no
don't know

A11-Treatment

Y

Radio button, scale, no
don't know

A11-Helpful

Y

Radio button, scale, no
don't know

Accessible

Y

Radio button, scale, no
don't know

Appearance

Y

Radio button, scale, no
don't know

Comfort

2
3
4
My need was addressed.

Strongly Agree=5
1=Strongly Disagree
2
3
4

It was easy to complete what I needed to do.

Strongly Agree=5
1=Strongly Disagree
2
3
4

It took a reasonable amount of time to do what I needed to do.

Strongly Agree=5
1=Strongly Disagree
2
3
4

I was treated fairly.

Strongly Agree=5
1=Strongly Disagree
2
3
4

Employees I interacted with were helpful.

Strongly Agree=5
1=Strongly Disagree
2
3
4

The office location is accessible and easy to locate.

Strongly Agree=5
1=Strongly Disagree
2
3
4

The office appearance was satisfactory.

Strongly Agree=5
1=Strongly Disagree
2
3
4

The office comfort was satisfactory.

Strongly Agree=5
1=Strongly Disagree
2
3
4

ForeSee Results - Confidential and Proprietary

The signs and instructions explaining how to check-in were
visible and easy to understand.

Strongly Agree=5
1=Strongly Disagree

Y

Radio button, scale, no
don't know

Check-in

Y

Radio button, scale, no
don't know

Waiting

Y

Radio button, scale, no
don't know

Privacy

Y

Radio button, scale, no
don't know

Knowledgeable

Y

Radio button, one-up
vertical

Skip Logic Group*

Primary Reason

N

Text field, <100 char

Skip Logic Group*

Y

Radio button, one-up
vertical

Skip Logic Group*

Primary Reason
Other
Online Aware
Apply

N

Text area, no char limit

Skip Logic Group*

Y

Radio button, one-up
vertical

Skip Logic Group*

N

Text area, no char limit

Skip Logic Group*

Y

Radio button, one-up
vertical

Skip Logic Group*

N

Text area, no char limit

Skip Logic Group*

Y

Radio button, one-up
vertical

Skip Logic Group*

N

Text area, no char limit

Skip Logic Group*

Y

Radio button, one-up
vertical

Skip Logic Group*

N

Text area, no char limit

Skip Logic Group*

2
3
4
Strongly Agree=5
The information located in the waiting area (posters, pamphlets, 1=Strongly Disagree
TV presentation) was helpful.
2
3
4
Strongly Agree=5
I had no concerns about other people hearing my conversation 1=Strongly Disagree
with the SSA representative.
2
3
4
The SSA representative who helped me was professional.

Strongly Agree=5
1=Strongly Disagree
2
3
4

What was the main reason for your visit to this Social Security
office?

Strongly Agree=5
Apply for Retirement/Survivor Benefits

A

First-time Social Security Card
Replacement/Update of my Social Security Card
Discuss an update to SSA (change of address, report work activity,
overpayment, etc.)

D

Please specify the main reason for your visit.

A

Were you aware that you can apply for retirement benefits
online at ssa.gov?

A1
B

B1
C

C1
E

E1
F

F1

Benefit verification letter
Check the status of my pending claim

E
F

Supplemental Security Income (SSI)
Apply for Disability Benefits
Medicare
Other, please specify

B
C
D

Yes

No
Why did you choose to visit a Social Security office instead of
applying online?
Were you aware that you can apply for Disability Benefits online Yes
at ssa.gov?
No
Why did you choose to visit a Social Security office instead of
applying for Disability Benefits online?
Yes
Were you aware that you can apply for Medicare online at
ssa.gov?
No
Why did you choose to visit a Social Security office instead of
applying for Medicare online?
Were you aware that you can view or print your benefit
Yes
verification letter online at ssa.gov?
No
Why did you choose to visit a Social Security office instead of
viewing or printing your benefit verification letter online?
Yes
Were you aware that you can check the status of a pending
claim online at ssa.gov?
No
Why did you choose to visit a Social Security office instead of
checking the status of an existing claim online?

A1

B1

C1

E1

F1

Why Not Apply
Online
Online Aware B

OE_Online Aware
B
Online Aware C

OE_Online Aware
C
Online Aware
Letter
OE_Online Aware
Letter
Online Aware
Status
OE_Online Aware
Status

ForeSee Results - Confidential and Proprietary

Were you able to accomplish what you needed to during this
office visit?

Yes

Radio button, one-up
vertical

Skip Logic Group*

Accomplish

Text area, no char limit

Skip Logic Group*

Y

Checkbox, one-up
vertical

Skip Logic Group*

Why Not
Accomplish
Do Next Not
Accomplish

N

Text area, no char limit

Y

Checkbox, one-up
vertical

Y

Radio button, one-up
vertical

Y

Radio button, one-up
vertical

Skip Logic Group*

Westchester
Pilot_On Behalf

Other
Yes

Y

Radio button, one-up
vertical

Skip Logic Group*

Westchester
Pilot_Appointment

No
At an interviewing window

Y

Checkbox, one-up
vertical

Skip Logic Group*

Westchester
Pilot_Rep Interact

No
A

Why were you unable to accomplish what you needed to?

B

What do you plan to do next in order to accomplish what you
need to? (Please select all that apply.)

Y
A, B

Visit this Social Security office again at a later date
Visit a different Social Security office
Call the Social Security National 800 number
Visit the Social Security website
Other, please specify
Not sure

B1

B1

Please specify what you plan to do next.
Did you do any of the following before your visit to this Social
Security office to try and accomplish what you needed to?

Yes, I had made a prior visit to this Social Security office

Mutually Exclusive
Skip Logic Group*

Do Next Other
Prior Attempt

Yes, I made a visit to another Social Security office
Yes, I called the National 800 number

Did you visit the Social Security office in Westchester, PA?

A

Did you visit Social Security for yourself or on behalf of
someone else?

Yes, I visited the website
No
Yes

A

No
Myself

Mutually Exclusive
Skip Logic Group*

Westchester Pilot

Someone else (e.g., child, parent, client)
Representative Payee or Payee Organization

A

Did you have an appointment?

A

How did you interact with a Social Security Representative
today? (select all that apply)

At the Innovation Lab assistance window
On a videophone in the Innovation Lab
I did not interact with a Social Security Representative today
A

What device(s) did you use today? (select all that apply)

B

Were you satisfied with the Smart Tablet experience?

B1

Why were you dissatisfied with the Smart Tablet experience?

C

Were you satisfied with the Express services computer desk
station?

C1

Why were you dissatisfied with the Express services computer
desk station?

D

Were you satisfied with the Self-Service Technology Center?

Mutually Exclusive

Smart Tablet

B

Express services computer desk station

C

Self-Service Technology Center (Benefit verification letter, benefit
estimate)

D

Information Center
Megan (Hologram)
I did not use any of the devices listed above

E
F

Yes

Skip Logic Group*

Y

Radio button, one-up
vertical

Skip Logic Group*

Westchester
Pilot_Smart Tablet

N

Text area, no char limit

Skip Logic Group*

OE_Westchester
Pilot_Smart Tablet

Y

Radio button, one-up
vertical

Skip Logic Group*

Westchester
Pilot_Express
Services

N

Text area, no char limit

Skip Logic Group*

Y

Radio button, one-up
vertical

Skip Logic Group*

OE_Westchester
Pilot_Express
Services
Westchester
Pilot_Self Serve

Westchester
Pilot_Device

B1

Yes
No

Checkbox, one-up
vertical

Mutually Exclusive

Yes
No

Y

C1

ForeSee Results - Confidential and Proprietary

No
D1

Why were you dissatisfied with the Self-Service Technology
Center?

E

Were you satisfied with the Information Center?

Yes
No

E1

Why were you dissatisfied with the Information Center?

F

Were you satisfied with our hologram unit Megan?

F1

Why were you dissatisfied with our hologram unit Megan?

A

Are you likely to use Social Security’s Self-Service tools in the
future?

M

Why aren't you likely to use the Self-Service tools?

A

Will you recommend Social Security’s Self-Service tools to
someone else?

N

Why Not?

A

Thinking about your reason for visiting today, would you be
comfortable doing the same business:

D1
OE_Westchester
Pilot_Self Serve

Y

Radio button, one-up
vertical

Skip Logic Group*

Westchester
Pilot_Info Center

N

Text area, no char limit

Skip Logic Group*

OE_Westchester
Pilot_Info Center

Y

Radio button, one-up
vertical

Skip Logic Group*

Westchester
Pilot_Hologram

N

Text area, no char limit

Skip Logic Group*

Y

Radio button, one-up
vertical

Skip Logic Group*

OE_Westchester
Pilot_Hologram
Westchester
Pilot_Tools

N

Text area, no char limit

Skip Logic Group*

Y

Radio button, one-up
vertical

Skip Logic Group*

N

Text area, no char limit

Skip Logic Group*

OE_Westchester
Pilot_Recommend

Y

Checkbox, one-up
vertical

Skip Logic Group*

Westchester
Pilot_Other
Channels

M

Yes
No

Skip Logic Group*

F1

Yes
No

Text area, no char limit

E1

Yes
No

N

OE_Westchester
Pilot_Tools Future
Use
Westchester
Pilot_Recommend

N

Over the phone
On the internet
Neither, I want to do this type of business in person

Mutually Exclusive

A

Do you have a mySocialSecurity account?

Yes

Y

Radio button, one-up
vertical

Skip Logic Group*

Westchester
Pilot_mySS
Account

A

Highest education completed:

No
Elementary school

N

Radio button, one-up
vertical

Skip Logic Group*

Westchester
Pilot_Demo
Education

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago Pilot

Y

Checkbox, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Reason

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Orange
Station

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Grey SSA
Card

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Informational
Video

Did you visit the Chicago Loop Social Security office on
Washington Blvd.?
A

Z

Z

Z

Why did you visit Social Security today?

Were you satisfied with the orange interview station that you
used to complete your Social Security card application?

High school
College
Advanced degree(s)
Prefer not to say
Yes

Disability
Replace Social Security Card
Medicare
Supplemental Security Income (SSI)
New Social Security Card
Other
Yes

No
Does not apply
Were you satisfied with the grey interview station that you used Yes
to complete your Social Security card application?

Did you find the informational video about the Social Security
card application (new, replacement, name change) useful when
checking in?

A

No
Retirement

No
Does not apply
Yes

Z

Z

No

ForeSee Results - Confidential and Proprietary

A

Did you visit Social Security for yourself or on behalf of
someone else?

Myself

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago Pilot_On
Behalf

Someone else (e.g., child, parent, client)
Representative Payee or Payee Organization

A

Did you have an appointment?

Other
Yes

B

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Appointment

B

Did you receive a barcoded Appointment Xpress letter?

No
Yes

C

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Barcode
Xpress

C

Would you prefer to receive the Appointment Xpress letter by
email or other electronic format?

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Letter Xpress

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Xpress
Appointment

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Xpress
Appointment Didnt
Use

Kiosk didn't work
Didn't see the kiosk
Didn't understand what to do
Other
Yes

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Xpress
Pictures

No
Yes

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago Pilot_QR
Code

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_iCalendar

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago Pilot_Toni

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Monitor

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Smart Phone

Y

Checkbox, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Interact

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Sound
Quality

Y

Checkbox, one-up
vertical

Skip Logic Group*

Chicago Pilot_Self
Help

C

D

No
Yes

No
Were you satisfied with the Appointment Xpress check-in kiosk Yes
and instructions?

Why not?

C

Did you find the pictures and instructions on the back of the
Appointment Xpress letter helpful?

C

Were you satisfied with the QR code and check-in process?

No
I did not use it
Forgot my letter

D

No
I have no idea what a QR code is or how to use one
C

C

C

A

A

Did you use the iCalendar feature to remind you of your
appointment?

Yes

No
Were you satisfied with the video instructions from “Toni ” in the Yes
entryway?
No
Did having the large screen monitor by the door help you to
Yes
check-in with Appointment Xpress?
No
Would you like the option to check in by your smart phone?
Yes

Please check all the ways you interacted with Social Security
today. (select all that apply)

E

Were you satisfied with the sound quality of your video
interview?

G

Please select why you chose Self-Help. (select all that apply)

No
Worked/talked with a Social Security Rep
On a self-service computer
On a video call
At an interviewing window
On a tablet
Using Live Chat
Other
Yes
No
Someone sent me to Self-Help
I prefer Self-Help
I saw a Self-Help video
The wait was shorter
I like to try new things
I followed the footsteps

E,G
E

Randomize

ForeSee Results - Confidential and Proprietary

Other
J

Please specify the reason you chose Self-Help.

G

Were you satisfied with today’s OVERALL Self-Help electronic
services experience?

G

Are you likely to use Social Security’s Self-Help tools in the
future?

A

Were you satisfied with your ability to hear the Social Security
representative in the office?

A1

Did the representative offer you a headset?

A

J
N

Radio button, one-up
vertical

Skip Logic Group*

No
Yes

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago Pilot_Self
Help Tools

No
Yes

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Hear Rep

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Headset

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Vidoes
Helpful

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Conduct
Online

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Tablet

Y

Checkbox, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Tablet
Businesses

N

Text area, no char limit

Skip Logic Group*

Yes

Y

Radio button, one-up
vertical

Skip Logic Group*

OE_Chicago
Pilot_Tablet
Businesses
OE_Chicago
Pilot_Tablet SSA
Card

No
Does not apply
Yes

Y

Radio button, one-up
vertical

Skip Logic Group*

Chicago Pilot_SSA
Card Help

No
Over the phone

Y

Checkbox, one-up
vertical

Skip Logic Group*

Chicago
Pilot_Comfort
Elsewhere

No
Yes

No
Did the videos encourage you to use the Self-Help/Self-Service Yes
options or conduct your business online?

A

Did you use the tablet in the waiting area to visit SSA.gov?

K

No
Please select all the business you attempted to complete on the Replacemt Social SecurityCard
tablet.

No
Yes

Replacement Medicare Card
Estimate Your Retirement Benefits
Create a mySocialSecurity Account
Change Your Address or Direct Deposit
Benefit Verification Letter
Other

A

Were you satisfied with the table mounted tablet interview
station that you used to complete my Social Security card
application?

A

Did completing the Social Security card application at the
interview station prior to your interview help you once you were
called?

A

Thinking about your reason for visiting today, would you be
comfortable doing the same business:

A1

K

L

On the internet
Neither. I want to do this type of business in person.
A

Please provide any additional comments.

A

Highest education completed:

OE_Chicago
Pilot_Self Help
Chicago
Pilot_Overall Self
Help

Y

A

Please specify what business you attempted to complete on the
tablet.

Anchor Answer Choice
Skip Logic Group*

Yes

No
Does not apply
Did you find the informational videos playing in the waiting area Yes
helpful?

L

Text area, no char limit

Elementary school

Mutually Exclusive
N

Text area, no char limit

Skip Logic Group*

N

Radio button, one-up
vertical

Skip Logic Group*

OE_Chicago
Pilot_Additional
Comments
Chicago
Pilot_Demo
Education

High school
College
Advanced degree(s)
Prefer not to say

ForeSee Results - Confidential and Proprietary