Financial Coaching Survey Host Sites and Partners

Privacy Notice
The Consumer Financial Protection Bureau (“CFPB” or “Bureau”) is gathering data to learn more about your experiences with the CFPB Financial
Coaching Initiative. Your participation in this survey will provide the Bureau with a deeper understanding of the impact of coaching services on host
sites and referral partners.
Participation is voluntary. You are not required to participate, and no identifying information will be collected.
Paperwork Reduction Act Statement

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and not withstanding any other provision of law a
person is not required to respond to a collection of information unless it displays a valid OMB control number. The OMB control number for this
collection is 3170-0036. It expires on 8/31/2019. The time required to complete this information collection is estimated to average approximately 30
minutes per response. Comments regarding this collection of information, including the estimated response time, suggestions for improving the
usefulness of the information, or suggestions for reducing the burden to respond to this collection should be submitted to the Consumer Financial
Protection Bureau (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to [email protected].
Please do not share any Personally Identifiable Information (PII), including, but not limited to, name, address, phone number, email address, etc. on this survey.
Section One: Local Relationship
Question Type
Question
Multiple Choice
1. How did you first learn about the CFPB’s financial coaching
program?

Choose up to 3

2. What categories best describe your organization? (choose up
to 3)

Response(s)
A. Call or email directly from coach
B. Event or workshop with coach
C. Recommendation from other organization
D. Marketing materials (business card, brochure, website,
etc.)
E. Don’t remember
F. Other (please specify)
A. Non-Profit (501(c)3)
B. City Government
C. State Government
D. Federal Government
E. Healthcare
F. Higher Education
G. Legal Services
H. Faith-Based
I. Active Duty Military
J. Reserve Component

Choose all that apply

Sliding Scale

3. Please select your organization’s service areas that referred
clients to our coaching program.

4. How important was each of the following considerations in your
organization’s decision to partner with the coaching service?
(Not important, Somewhat important, Important, Extremely
important)

K.
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
A.
B.
C.
D.
E.
F.

Contingent: Multiple
Choice (only ask if
options H and/or I are
chosen in Section 1
Question #2)

5. Please identify the options that best reflect your organization’s
connections to the Servicemember Community.

Section Two: Integration
Question Type
Question
Matrix
1. What does your organization’s partnership with your local
coach look like? (each option has Yes/No/Not Sure)

Multiple Choice

2. Which of these categories best describes how your organization
encouraged clients to meet with the coach?

A.
B.
C.
D.
E.
G.

Veteran Only
Workforce Development
Public Assistance Programs
Homeownership
Tax Time Support (includes Volunteer Income Tax
Assistance or VITA)
Small Business Development
Student Services
Mental Health Services
Addiction/Rehabilitation Services
Veteran Benefits
Other (please specify)
Program’s affiliation with the CFPB
Coach’s credentials (Accredited Financial Counselor or
AFC /Financial Fitness Coach or FFC certifications)
Focus on Veterans
Individual coach’s experience and background
Financial coaching addressed a service gap for my
organization’s clients
Coaching program’s relationships with other local
organizations
Vet Center
Veteran Treatment Court
Veterans Affairs Hospital
State/County Veteran Services
Non-Profit Veteran Program/Organization
Other (please specify)

Response(s)
A. We refer clients to the coach
B. The coach offers 1:1 coaching at my organization
C. The coach gives presentations and/or workshops for my
organization
D. The coach has regularly scheduled hours at my
organization
E. Other (please specify)
A. Clients were required to participate in coaching to access
services or benefits

Multiple Choice

3. How would you describe the integration of coaching into your
organization’s existing services?

Multiple Choice

4. Did your organization have a process for identifying which
clients to connect to the Financial Coach?
Open response
5. How did staff at your organization identify which clients to
connect to the Financial Coach?
Section Three: Sustainability
Question Type
Question
Multiple Choice
1. How beneficial do you believe financial coaching services have
been to the clients your organization serves?

Multiple Choice +
Optional Explain

2. If the program did not end in March, would you continue to
partner with the financial coach?

Multiple Choice

[include an optional “please explain” box with this question]
3. Is your organization actively seeking to continue financial
coaching or a similar service in your community?

Multiple Choice

4. Does a similar service already exist in your community that
adequately replaces the CFPB Financial Coaching Program?

Contingent: Open
Response (Only ask if
respondent answers

5. What challenges or barriers could you or have you faced in
attempting to ensure Financial Coaching services stay in your
community?

B. Clients were offered an incentive to participate in
coaching
C. Clients received information about coaching, but there
was no incentive or requirement for clients to meet with
the coach
D. Other (please specify)
E. Not sure
A. All clients were offered coaching (for example, coaching
options were included on intake forms)
B. Most clients were offered coaching
C. Some clients were offered coaching
D. Very few clients were offered coaching
E. Not sure
A. Yes
B. No

Response(s)
A. Very beneficial
B. Beneficial
C. A little beneficial
D. Not at all beneficial
E. Not sure
A. Yes
B. No
C. Maybe
D. Not sure
A. Yes
B. No
A. Yes
B. No
C. Not sure

“yes” to Section 3,
Question #3)
Section Four: Overall Experience, feedback and suggestions
Question Type
Question
Open Response
1. What aspects of this program helped make it successful?
Open Response
2. What aspects of this program created challenges or barriers to
success?
Section Five: Demographics
Question Type
Question
Multiple Choice
1. What best describes your role in your organization?

Multiple Choice
Multiple Choice

Multiple Choice

Response(s)

Response(s)
A. Administrator
B. Program Manager
C. Front-Line Service Provider
A. Other (write in)
2. What type of community is your site/program?
B. Urban
C. Semi-Urban/Suburban
D. Rural
3. What percentage of your organization’s clients would you
A. 80-100% of my organization’s clients have a household
estimate are below the poverty level?
income at or below Federal poverty level
(For state-by-state guidance on Federal Poverty Levels, please
B. 50-80% of my organization’s clients have a household
see
income at or below Federal poverty level
https://www.federalregister.gov/documents/2018/01/18/2018- C. Less than 50% of my organization’s clients have a
00814/annual-update-of-the-hhs-poverty-guidelines)
household income at or below Federal poverty level
D. Not sure
4. In what region is your site/program located?
A. Mid Atlantic (DC, MD, NJ, NY, PA, VA, WV)
B. Midwest (IL, IN, MI, MN, MO, OH, WI)
C. Mountain (AZ, CO, NV, OK, TX)
D. New England (CT, ME, MA, NH, RI, VT)
E. Plains (ID, KS, MT, NE, ND, SD)
F. South (AL, AR, FL, GA, KY, LA, MS)
G. West Coast (AK, CA, HI, OR, WA)