O MB#: 1121-XXXX Call Center
Date of Expiration: XXXX Feedback Form
We have identified you as someone who has recently been in contact with the OVC TTAC Call Center. In order to help OVC TTAC better serve the field, we are reaching out to obtain your feedback. We will protect the privacy of your information in accordance with the Federal Privacy Act, and we will protect the confidentiality of your responses using procedures we have in place. Only members of the Evaluation Team have access to information that could identify respondents. Answers to these questions will only be reported after aggregating all responses, and the results will never identify you as an individual. Other participants/users, consultants/presenters, OVC staff, OVC TTAC staff, and your employer will not have access to what you as an individual say. Your participation is in this survey is completely voluntary. If you have any questions about this survey or the evaluation, please contact [email protected].
Please indicate the extent to which you agree or disagree with the following statements.
OVERALL ASSISTANCE |
Strongly Disagree |
Disagree |
Neither Agree nor Disagree |
Agree |
Strongly Agree |
Not Applicable |
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□ Via the OVC TTAC Website
□ Via an exhibit or presentation at a conference
□ Via a link from another website/Searching the Internet
□ Via a colleague or friend
□ Via a publication or newsletter
□ Via my OVC program monitor or other OVC staff person
□ Other (please specify): ________________________________________________________________________________
How often have you used OVC TTAC in the last 12 months? (Mark one.)
□ 1 – 3 times □ 7 – 9 times
□ 4 – 6 times □ 10+ times
How did you access OVC TTAC? (Mark all that apply.)
□ OVC TTAC Website □ E-mail
□ Toll-free number for call center □ TTY
□ OVC program monitor or other OVC staff person □ Other (please specify): __________________________
Why did you use/contact OVC TTAC? (Mark all that apply.)
□ Request general information about OVC or OVC TTAC □ Request or apply for assistance:
□ Obtain general information about victim services □ Technical assistance
□ Obtain a referral for direct services □ Training
□ Access online materials or training □ Funding for a conference/event or speaker
□ Join the listserv or mailing list □ Scholarship
□ Apply to be a consultant/trainer □ National Victim Assistance Academy
□ Acquire help for technical problems on website □ Other (please specify): __________________________
In general, how promptly was your request acknowledged? (Mark one.)
□ Immediately □ Within 2-3 days □ More than a week
□ Within a day □ Within a week □ My request was not acknowledged
Would you recommend OVC TTAC to others? □ Yes □ No
What did you find most helpful about OVC TTAC’s resources?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
What could be done differently to improve your experience with OVC TTAC?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Do you have any other comments or suggestions?
____________________________________________________________________________________
____________________________________________________________________________________
Which of the following best describes the organization in which you work? (Mark all that apply.)
□ Community-Based/Grassroots □ Health/Mental Health Services □ Military
□ Criminal Justice Agency □ Human/Social Services □ Research
□ Education □ Legal Services □ Other (please specify):
□ Faith-Based □ Legislation/Policymaking _________________________
Which types of victim services do you provide for crime victims in your current position? (Mark all that apply.)
□ I do not provide direct services □ Criminal Justice System □ Notification
□ Child Care Advocacy/Assistance □ Transportation
□ Compensation/Restitution □ Housing/Shelter □ 24-Hour Hotline
□ Counseling □ Information/Referral □ Other (please specify):
□ Crisis Intervention □ Medical/SANE/SART _________________________
Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years □ 3 to 5 years □ 6 to 10 years □ More than 10 years
Which of the following best describes your primary role in your current position? (Mark all that apply.)
□ Direct Delivery/Front Line Staff □ Consultant/Trainer □ Other (please specify):
□ Management/Administrative Staff □ Volunteer _________________________
Which of the following best describes the population you serve? (Mark all that apply.)
□ National □ Local
□ State □ Urban
□ Tribal □ Rural
□ International, list country: □ Suburban
_________________________________ □ Culturally specific populations(s): ________________________
Thank you for taking the time to complete this form and helping to improve OVC TTAC activities.
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or additional suggestions, please write to the OVC TTAC evaluation team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Field, Michael |
File Modified | 0000-00-00 |
File Created | 2021-01-15 |