Feedback Survey PDF

OMB No. 0524-0050
Form Approved For Use Through TBD

Veterinary Medicine Loan Repayment Program
Process and Shortage Area Feedback Survey
The purposes of this survey are to A) obtain your assessment of the Veterinary Medicine Loan
Repayment Program (VMLRP) shortage area you are currently serving and B) gather feedback on VMLRP
administrative processes. Your responses will facilitate continuous improvement and evaluation of the
VMLRP and help inform State Animal Health Officials (SAHOs) as they develop shortage nominations.
Any reporting of information provided in this survey will be in aggregate, so your individual responses
will be anonymous. Information provided to SAHOs regarding your specific shortage area will be devoid
of personally identifiable information. The survey contains 20 questions and should take approximately
20 minutes to complete. Participation in this survey is voluntary. You may opt to skip any question you
prefer not to answer.
The VMLRP Staff thanks you for your time and feedback.
A. SHORTAGE SITUATION
SHORTAGE SITUATION ID __________
1. Are more food animal veterinarians needed to meet the current needs in your shortage area?

Please explain why.

2. Do you anticipate a significant change in these needs in the next 3-5 years?

Please explain why.

3. Does the shortage nomination form clearly outline the location and types of services you should
provide to mitigate the current shortage?

Veterinary Medicine Loan Repayment Program
Process and Shortage Area Feedback Survey
B. ADMINISTRATIVE PROCESSES
1. Using a scale from 1 to 5, where 1 is “Poor” and 5 is “Excellent”, please rate the following factors
with respect to the VMLRP application process. If a question does not apply to you, please put
“N/A.”
____Clarity and ease of understanding the program guidance documents
____Ease of gathering the information required to fill out the application
____Amount of time required to complete the application
____Ease of submitting the application and supporting documents
____Responsiveness of support from VMLRP staff
____Sufficiency of support from VMLRP staff
____Timeliness of award notification
____Ease of understanding of award terms and conditions

2. Using a scale from 1 to 5, where 1 is “Poor” and 5 is “Excellent”, please rate the service and payment
verification process on the following statements. If this question does not apply to you, please put
“N/A.”
____Promptness of receiving the service verification form by email
____Promptness of receiving loan payment
____Responsiveness of support for payment issues
____Promptness of receiving tax payment
3. In the past 12 months, how would you rate the frequency of communications received from
VMLRP?

4a. In addition to service and payment verifications, would you like to receive other communications
(like a newsletter) from VMLRP?

4b. If Yes, how often?

4c.

If Yes, please provide suggestions for content:

5. Would you be interested in participating in a voluntary list-serv with other VMLRP award recipients
(current and alumni)?

Veterinary Medicine Loan Repayment Program
Process and Shortage Area Feedback Survey
6. What type of information would you like to see on the VMLRP website that is not currently available?

7. Please think about your overall experience while visiting the VMLRP website in the past 12 months.
Using a scale from 1 to 5, where 1 means “Poor” and 5 is “Excellent”, please rate:
____Ease of navigation
____Usefulness of the information provided
____Relevance of search results
____Ability to find the information needed
8. Have you contacted VMLRP during the past 12 months?

9. In the past 12 months, through what means have you contacted the VMLRP? (Select all that apply)
Telephone
E-mail
Fax
Other (please specify) _____________________________________________
10. Please select all the reasons that you contacted the VMLRP in the past 12 months.
General information
Program requirements
Renewal application question
Maternity/paternity/adoption leave
Quarterly service verification
Service log
Payment issues
Payment verification
Update contact information
Update loan information
Request tax information
Other (please specify) ___________________________________________________________

Veterinary Medicine Loan Repayment Program
Process and Shortage Area Feedback Survey
11. Of all the reasons you selected for contacting VMLRP in the past 12 months, what was the reason
for your most recent contact?
General information
Program requirements
Renewal application question
Maternity/paternity/adoption leave
Quarterly service verification
Service log
Payment issues
Payment verification
Update contact information
Update loan information
Request tax information
Other (please specify) __________________________________________________________
12. For your most recent contact, approximately how long did it take VMLRP to respond to your
inquiry?

13. Were you satisfied with the time required to obtain this response?

14. If you could change one thing about any of the processes managed by VMLRP, what would it be?

15. Please provide any other comments about VMLRP processes or recommendations for improvement.

Public reporting for collection of information is estimated to average 20 minutes, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the date needed, and completing and reviewing the collection of information. An agency may not conduct or
sponsor, and a person is not required to respond to, a collection of information, unless it displays a current valid OMB control number. Send comments
regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to NIFA, OEP, 800 9th
St. SW, Washington, DC 20024, Attention Policy Section. Do not return the completed form to this address.
OMB No. 0524-NEW