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pdfBureau of Consumer Financial Protection
Customer Experience Survey #1
CEE: Pre-Event Survey
Purpose: Measure customer needs and concerns before an event occurs.
Privacy Notice
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate any pre-event needs by the Consumer Education
and Engagement Division.
The Bureau will not collect any personally identifiable information from you.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.]
(drop down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop
down menu ▼ or open field)
2. What are you hoping to get out of the
event? (click all that apply)
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
3. How confident do you feel in your
knowledge of [SUBJECT MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How do you feel about the location of the
event?
�
�
�
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
5. How did you hear about this event?
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
☐ Other: (open field)
6. Do you have any accessibility needs we
can help with?
� No
� Yes (with open text field)
7. How can we make [EVENT] valuable to
you?
Open-ended
8. What should we do to ensure this event
[MEETS YOUR NEEDS / IS A SUCCESS]?
Open-ended
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #2
CEE: Post-Event Survey
Purpose: Measure customer satisfaction after Bureau events and trainings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used post-event to evaluate any Consumer Education and
Engagement Division programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.] (drop
down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop down
menu ▼ or open field)
�
�
�
2. Overall, how would you rate your satisfaction �
with this event?
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
3. After attending our event, how confident do
you feel in your knowledge of [SUBJECT
MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How effective were the presentations on
conveying the materials?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
� Not at all
� Slightly
� Moderately
� Very
5. How useful will this material be in your work? � Extremely
�
�
6. How would you rate your satisfaction with the �
presenter(s)?
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
7. Was the venue and content fully accessible
to you?
� Yes
� No (with text box)
8. Would you recommend this
workshop/session to someone else in your
position?
� Yes
� No
9. Employees I interacted with were helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
10. I felt comfortable asking questions.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
11. Did you experience any technical
difficulties? If yes, briefly explain.
� No
� Yes (with text box)
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
12. How did you hear about this event? (click all ☐ [INSERT OPTION]
that apply)
☐ Other: (open field)
13. What could we improve for next time?
Open Ended
14. Please provide any additional comments
you may have.
Open Ended
Could we contact you if we have any more
questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #3
CEE: General Engagement Survey
Purpose: A general multi-purpose survey for Bureau web and print products, events and
meetings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate general engagement of any Consumer Education
and Engagement Division programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of the Consumer
Financial Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by
email to [email protected].
Goal
Question
Satisfaction
� Extremely Dissatisfied
� Dissatisfied
1. Please rate your OVERALL level of � Neutral
satisfaction with [SERVICE OR
� Satisfied
PROGRAM]?
� Extremely Satisfied
Confidence
Value
2. This [EVENT / PRODUCT /
INTERACTION] increased my
confidence in [SUBJECT MATTER].
3. The purpose of my attending the
event is (check all that apply):
Answer Options
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
4. My need(s) was / were addressed
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Ease
5. It was easy to complete what I
needed to do.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Efficiency
� Strongly Disagree
� Disagree
� Neutral
6. It took a reasonable amount of time � Agree
to do what I needed to do.
� Strongly Agree
Value
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Equality
7. I was treated fairly.
Inviting
� Strongly Disagree
� Disagree
� Neutral
8. I felt comfortable asking questions. � Agree
� Strongly Agree
� N/A
Employees
9. Employees I interacted with were
helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
Technical
10. Did you experience any technical � No
difficulties? If yes, briefly explain.
� Yes (with text box)
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Trust
11. I trust the information the Bureau
produces about [TOPIC].
Overall
improvement
12. If we could make one
improvement, what should it be?
Open Ended
Overall
improvement
13. What additional comments do you
have?
Open Ended
Overall
improvement
Could we contact you if we have any
more questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #1
External Affairs: Pre-Event Survey
Purpose: Measure customer needs and concerns before an event occurs.
Privacy Notice
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate any pre-event needs by the External Affairs
Division.
The Bureau will not collect any personally identifiable information from you.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.]
(drop down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop
down menu ▼ or open field)
2. What are you hoping to get out of the
event? (click all that apply)
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
3. How confident do you feel in your
knowledge of [SUBJECT MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How do you feel about the location of the
event?
�
�
�
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
5. How did you hear about this event?
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
☐ Other: (open field)
6. Do you have any accessibility needs we
can help with?
� No
� Yes (with open text field)
7. How can we make [EVENT] valuable to
you?
Open-ended
8. What should we do to ensure this event
[MEETS YOUR NEEDS / IS A SUCCESS]?
Open-ended
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #2
External Affairs: Post-Event Survey
Purpose: Measure customer satisfaction after Bureau events and trainings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used post-event to evaluate any Front Office programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.] (drop
down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop down
menu ▼ or open field)
�
�
�
2. Overall, how would you rate your satisfaction �
with this event?
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
3. After attending our event, how confident do
you feel in your knowledge of [SUBJECT
MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How effective were the presentations on
conveying the materials?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
� Not at all
� Slightly
� Moderately
� Very
5. How useful will this material be in your work? � Extremely
�
�
6. How would you rate your satisfaction with the �
presenter(s)?
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
7. Was the venue and content fully accessible
to you?
� Yes
� No (with text box)
8. Would you recommend this
workshop/session to someone else in your
position?
� Yes
� No
9. Employees I interacted with were helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
10. I felt comfortable asking questions.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
11. Did you experience any technical
difficulties? If yes, briefly explain.
� No
� Yes (with text box)
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
12. How did you hear about this event? (click all ☐ [INSERT OPTION]
that apply)
☐ Other: (open field)
13. What could we improve for next time?
Open Ended
14. Please provide any additional comments
you may have.
Open Ended
Could we contact you if we have any more
questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #3
External Affairs: General Engagement Survey
Purpose: A general multi-purpose survey for Bureau web and print products, events and
meetings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate general engagement of any External Affairs
Division programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of the Consumer
Financial Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by
email to [email protected].
Goal
Question
Satisfaction
� Extremely Dissatisfied
� Dissatisfied
1. Please rate your OVERALL level of � Neutral
satisfaction with [SERVICE OR
� Satisfied
PROGRAM]?
� Extremely Satisfied
Confidence
Value
2. This [EVENT / PRODUCT /
INTERACTION] increased my
confidence in [SUBJECT MATTER].
3. The purpose of my attending the
event is (check all that apply):
Answer Options
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
4. My need(s) was / were addressed
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Ease
5. It was easy to complete what I
needed to do.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Efficiency
� Strongly Disagree
� Disagree
� Neutral
6. It took a reasonable amount of time � Agree
to do what I needed to do.
� Strongly Agree
Value
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Equality
7. I was treated fairly.
Inviting
� Strongly Disagree
� Disagree
� Neutral
� Agree
8. I felt comfortable asking questions. � Strongly Agree
� N/A
Employees
9. Employees I interacted with were
helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
Technical
10. Did you experience any technical � No
difficulties? If yes, briefly explain.
� Yes (with text box)
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Trust
11. I trust the information the Bureau
produces about [TOPIC].
Overall
improvement
12. If we could make one
improvement, what should it be?
Open Ended
Overall
improvement
13. What additional comments do you
have?
Open Ended
Overall
improvement
Could we contact you if we have any
more questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #1
Front Office: Pre-Event Survey
Purpose: Measure customer needs and concerns before an event occurs.
Privacy Notice
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate any pre-event needs by the Front Office.
The Bureau will not collect any personally identifiable information from you.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.]
(drop down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop
down menu ▼ or open field)
2. What are you hoping to get out of the
event? (click all that apply)
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
3. How confident do you feel in your
knowledge of [SUBJECT MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How do you feel about the location of the
event?
�
�
�
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
5. How did you hear about this event?
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
☐ Other: (open field)
6. Do you have any accessibility needs we
can help with?
� No
� Yes (with open text field)
7. How can we make [EVENT] valuable to
you?
Open-ended
8. What should we do to ensure this event
[MEETS YOUR NEEDS / IS A SUCCESS]?
Open-ended
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #2
Front Office: Post-Event Survey
Purpose: Measure customer satisfaction after Bureau events and trainings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used post-event to evaluate any Front Office programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.] (drop
down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop down
menu ▼ or open field)
�
�
�
2. Overall, how would you rate your satisfaction �
with this event?
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
3. After attending our event, how confident do
you feel in your knowledge of [SUBJECT
MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How effective were the presentations on
conveying the materials?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
� Not at all
� Slightly
� Moderately
� Very
5. How useful will this material be in your work? � Extremely
�
�
6. How would you rate your satisfaction with the �
presenter(s)?
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
7. Was the venue and content fully accessible
to you?
� Yes
� No (with text box)
8. Would you recommend this
workshop/session to someone else in your
position?
� Yes
� No
9. Employees I interacted with were helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
10. I felt comfortable asking questions.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
11. Did you experience any technical
difficulties? If yes, briefly explain.
� No
� Yes (with text box)
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
12. How did you hear about this event? (click all ☐ [INSERT OPTION]
that apply)
☐ Other: (open field)
13. What could we improve for next time?
Open Ended
14. Please provide any additional comments
you may have.
Open Ended
Could we contact you if we have any more
questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #3
Front Office: General Engagement Survey
Purpose: A general multi-purpose survey for Bureau web and print products, events and
meetings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate general engagement of any Front Office
programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of the Consumer
Financial Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by
email to [email protected].
Goal
Question
Satisfaction
� Extremely Dissatisfied
� Dissatisfied
1. Please rate your OVERALL level of � Neutral
satisfaction with [SERVICE OR
� Satisfied
PROGRAM]?
� Extremely Satisfied
Confidence
Value
2. This [EVENT / PRODUCT /
INTERACTION] increased my
confidence in [SUBJECT MATTER].
3. The purpose of my attending the
event is (check all that apply):
Answer Options
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
4. My need(s) was / were addressed
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Ease
5. It was easy to complete what I
needed to do.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Efficiency
� Strongly Disagree
� Disagree
� Neutral
6. It took a reasonable amount of time � Agree
to do what I needed to do.
� Strongly Agree
Value
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Equality
7. I was treated fairly.
Inviting
� Strongly Disagree
� Disagree
� Neutral
8. I felt comfortable asking questions. � Agree
� Strongly Agree
� N/A
Employees
9. Employees I interacted with were
helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
Technical
10. Did you experience any technical � No
difficulties? If yes, briefly explain.
� Yes (with text box)
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Trust
11. I trust the information the Bureau
produces about [TOPIC].
Overall
improvement
12. If we could make one
improvement, what should it be?
Open Ended
Overall
improvement
13. What additional comments do you
have?
Open Ended
Overall
improvement
Could we contact you if we have any
more questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #1
Legal: Pre-Event Survey
Purpose: Measure customer needs and concerns before an event occurs.
Privacy Notice
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate any pre-event needs by the Legal Division.
The Bureau will not collect any personally identifiable information from you.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.]
(drop down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop
down menu ▼ or open field)
2. What are you hoping to get out of the
event? (click all that apply)
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
3. How confident do you feel in your
knowledge of [SUBJECT MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How do you feel about the location of the
event?
�
�
�
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
5. How did you hear about this event?
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
☐ Other: (open field)
6. Do you have any accessibility needs we
can help with?
� No
� Yes (with open text field)
7. How can we make [EVENT] valuable to
you?
Open-ended
8. What should we do to ensure this event
[MEETS YOUR NEEDS / IS A SUCCESS]?
Open-ended
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #2
Legal: Post-Event Survey
Purpose: Measure customer satisfaction after Bureau events and trainings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used post-event to evaluate any Legal Division programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.] (drop
down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop down
menu ▼ or open field)
�
�
�
2. Overall, how would you rate your satisfaction �
with this event?
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
3. After attending our event, how confident do
you feel in your knowledge of [SUBJECT
MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How effective were the presentations on
conveying the materials?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
� Not at all
� Slightly
� Moderately
� Very
5. How useful will this material be in your work? � Extremely
�
�
6. How would you rate your satisfaction with the �
presenter(s)?
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
7. Was the venue and content fully accessible
to you?
� Yes
� No (with text box)
8. Would you recommend this
workshop/session to someone else in your
position?
� Yes
� No
9. Employees I interacted with were helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
10. I felt comfortable asking questions.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
11. Did you experience any technical
difficulties? If yes, briefly explain.
� No
� Yes (with text box)
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
12. How did you hear about this event? (click all ☐ [INSERT OPTION]
that apply)
☐ Other: (open field)
13. What could we improve for next time?
Open Ended
14. Please provide any additional comments
you may have.
Open Ended
Could we contact you if we have any more
questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #3
Legal: General Engagement Survey
Purpose: A general multi-purpose survey for Bureau web and print products, events and
meetings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate general engagement of any Legal Division
programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of the Consumer
Financial Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by
email to [email protected].
Goal
Question
Satisfaction
� Extremely Dissatisfied
� Dissatisfied
1. Please rate your OVERALL level of � Neutral
satisfaction with [SERVICE OR
� Satisfied
PROGRAM]?
� Extremely Satisfied
Confidence
Value
2. This [EVENT / PRODUCT /
INTERACTION] increased my
confidence in [SUBJECT MATTER].
3. The purpose of my attending the
event is (check all that apply):
Answer Options
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
4. My need(s) was / were addressed
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Ease
5. It was easy to complete what I
needed to do.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Efficiency
� Strongly Disagree
� Disagree
� Neutral
6. It took a reasonable amount of time � Agree
to do what I needed to do.
� Strongly Agree
Value
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Equality
7. I was treated fairly.
Inviting
� Strongly Disagree
� Disagree
8. I felt comfortable asking questions. � Neutral
� Agree
� Strongly Agree
� N/A
Employees
9. Employees I interacted with were
helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
Technical
10. Did you experience any technical � No
difficulties? If yes, briefly explain.
� Yes (with text box)
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Trust
11. I trust the information the Bureau
produces about [TOPIC].
Overall
improvement
12. If we could make one
improvement, what should it be?
Open Ended
Overall
improvement
13. What additional comments do you
have?
Open Ended
Overall
improvement
Could we contact you if we have any
more questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #1
Operations: Pre-Event Survey
Purpose: Measure customer needs and concerns before an event occurs.
Privacy Notice
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate any pre-event needs by the Operations Division.
The Bureau will not collect any personally identifiable information from you.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.]
(drop down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop
down menu ▼ or open field)
2. What are you hoping to get out of the
event? (click all that apply)
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
3. How confident do you feel in your
knowledge of [SUBJECT MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How do you feel about the location of the
event?
�
�
�
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
5. How did you hear about this event?
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
☐ Other: (open field)
6. Do you have any accessibility needs we
can help with?
� No
� Yes (with open text field)
7. How can we make [EVENT] valuable to
you?
Open-ended
8. What should we do to ensure this event
[MEETS YOUR NEEDS / IS A SUCCESS]?
Open-ended
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #2
Operations: Post-Event Survey
Purpose: Measure customer satisfaction after Bureau events and trainings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used post-event to evaluate any Operations Division programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.] (drop
down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop down
menu ▼ or open field)
�
�
�
2. Overall, how would you rate your satisfaction �
with this event?
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
3. After attending our event, how confident do
you feel in your knowledge of [SUBJECT
MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How effective were the presentations on
conveying the materials?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
� Not at all
� Slightly
� Moderately
� Very
5. How useful will this material be in your work? � Extremely
�
�
6. How would you rate your satisfaction with the �
presenter(s)?
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
7. Was the venue and content fully accessible
to you?
� Yes
� No (with text box)
8. Would you recommend this
workshop/session to someone else in your
position?
� Yes
� No
9. Employees I interacted with were helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
10. I felt comfortable asking questions.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
11. Did you experience any technical
difficulties? If yes, briefly explain.
� No
� Yes (with text box)
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
12. How did you hear about this event? (click all ☐ [INSERT OPTION]
that apply)
☐ Other: (open field)
13. What could we improve for next time?
Open Ended
14. Please provide any additional comments
you may have.
Open Ended
Could we contact you if we have any more
questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #3
Operations: General Engagement Survey
Purpose: A general multi-purpose survey for Bureau web and print products, events and
meetings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate general engagement of any Operations Division
programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of the Consumer
Financial Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by
email to [email protected].
Goal
Question
Satisfaction
� Extremely Dissatisfied
� Dissatisfied
1. Please rate your OVERALL level of � Neutral
satisfaction with [SERVICE OR
� Satisfied
PROGRAM]?
� Extremely Satisfied
Confidence
Value
2. This [EVENT / PRODUCT /
INTERACTION] increased my
confidence in [SUBJECT MATTER].
3. The purpose of my attending the
event is (check all that apply):
Answer Options
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
4. My need(s) was / were addressed
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Ease
5. It was easy to complete what I
needed to do.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Efficiency
� Strongly Disagree
� Disagree
� Neutral
6. It took a reasonable amount of time � Agree
to do what I needed to do.
� Strongly Agree
Value
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Equality
7. I was treated fairly.
Inviting
� Strongly Disagree
� Disagree
8. I felt comfortable asking questions. � Neutral
� Agree
� Strongly Agree
� N/A
Employees
9. Employees I interacted with were
helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
Technical
10. Did you experience any technical � No
difficulties? If yes, briefly explain.
� Yes (with text box)
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Trust
11. I trust the information the Bureau
produces about [TOPIC].
Overall
improvement
12. If we could make one
improvement, what should it be?
Open Ended
Overall
improvement
13. What additional comments do you
have?
Open Ended
Overall
improvement
Could we contact you if we have any
more questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #1
RMR: Pre-Event Survey
Purpose: Measure customer needs and concerns before an event occurs.
Privacy Notice
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate any pre-event needs by the Research, Markets,
and Regulations Division.
The Bureau will not collect any personally identifiable information from you.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.]
(drop down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop
down menu ▼ or open field)
2. What are you hoping to get out of the
event? (click all that apply)
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
3. How confident do you feel in your
knowledge of [SUBJECT MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How do you feel about the location of the
event?
�
�
�
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
5. How did you hear about this event?
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
☐ Other: (open field)
6. Do you have any accessibility needs we
can help with?
� No
� Yes (with open text field)
7. How can we make [EVENT] valuable to
you?
Open-ended
8. What should we do to ensure this event
[MEETS YOUR NEEDS / IS A SUCCESS]?
Open-ended
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #2
RMR: Post-Event Survey
Purpose: Measure customer satisfaction after Bureau events and trainings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used post-event to evaluate any Research, Markets, and
Regulations Division programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.] (drop
down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop down
menu ▼ or open field)
�
�
�
2. Overall, how would you rate your satisfaction �
with this event?
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
3. After attending our event, how confident do
you feel in your knowledge of [SUBJECT
MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How effective were the presentations on
conveying the materials?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
� Not at all
� Slightly
� Moderately
� Very
5. How useful will this material be in your work? � Extremely
�
�
6. How would you rate your satisfaction with the �
presenter(s)?
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
7. Was the venue and content fully accessible
to you?
� Yes
� No (with text box)
8. Would you recommend this
workshop/session to someone else in your
position?
� Yes
� No
9. Employees I interacted with were helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
10. I felt comfortable asking questions.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
11. Did you experience any technical
difficulties? If yes, briefly explain.
� No
� Yes (with text box)
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
12. How did you hear about this event? (click all ☐ [INSERT OPTION]
that apply)
☐ Other: (open field)
13. What could we improve for next time?
Open Ended
14. Please provide any additional comments
you may have.
Open Ended
Could we contact you if we have any more
questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #3
RMR: General Engagement Survey
Purpose: A general multi-purpose survey for Bureau web and print products, events and
meetings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate general engagement of any Research, Markets,
and Regulations Division programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of the Consumer
Financial Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by
email to [email protected].
Goal
Question
Satisfaction
� Extremely Dissatisfied
� Dissatisfied
1. Please rate your OVERALL level of � Neutral
satisfaction with [SERVICE OR
� Satisfied
PROGRAM]?
� Extremely Satisfied
Confidence
Value
2. This [EVENT / PRODUCT /
INTERACTION] increased my
confidence in [SUBJECT MATTER].
3. The purpose of my attending the
event is (check all that apply):
Answer Options
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
4. My need(s) was / were addressed
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Ease
5. It was easy to complete what I
needed to do.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Efficiency
� Strongly Disagree
� Disagree
� Neutral
6. It took a reasonable amount of time � Agree
to do what I needed to do.
� Strongly Agree
Value
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Equality
7. I was treated fairly.
Inviting
� Strongly Disagree
� Disagree
8. I felt comfortable asking questions. � Neutral
� Agree
� Strongly Agree
� N/A
Employees
9. Employees I interacted with were
helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
Technical
10. Did you experience any technical � No
difficulties? If yes, briefly explain.
� Yes (with text box)
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Trust
11. I trust the information the Bureau
produces about [TOPIC].
Overall
improvement
12. If we could make one
improvement, what should it be?
Open Ended
Overall
improvement
13. What additional comments do you
have?
Open Ended
Overall
improvement
Could we contact you if we have any
more questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #1
SEFL: Pre-Event Survey
Purpose: Measure customer needs and concerns before an event occurs.
Privacy Notice
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate any pre-event needs by the Supervision,
Enforcement, Fair Lending & Equal Opportunity Division.
The Bureau will not collect any personally identifiable information from you.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.]
(drop down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop
down menu ▼ or open field)
2. What are you hoping to get out of the
event? (click all that apply)
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
3. How confident do you feel in your
knowledge of [SUBJECT MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How do you feel about the location of the
event?
�
�
�
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
5. How did you hear about this event?
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
☐ Other: (open field)
6. Do you have any accessibility needs we
can help with?
� No
� Yes (with open text field)
7. How can we make [EVENT] valuable to
you?
Open-ended
8. What should we do to ensure this event
[MEETS YOUR NEEDS / IS A SUCCESS]?
Open-ended
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #2
SEFL: Post-Event Survey
Purpose: Measure customer satisfaction after Bureau events and trainings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used post-event to evaluate any Supervision, Enforcement, Fair
Lending & Equal Opportunity Division.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of Consumer Financial
Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to
[email protected].
Question
Answer Options
1. Please let us know where you work.
Part 1 - [Department / Org / Sector / Etc.] (drop
down menu ▼ or open field)
Part 2 - [Sub-category. Ex. Local gov] (drop down
menu ▼ or open field)
�
�
�
2. Overall, how would you rate your satisfaction �
with this event?
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
3. After attending our event, how confident do
you feel in your knowledge of [SUBJECT
MATTER]?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
4. How effective were the presentations on
conveying the materials?
� Not at all
� Slightly
� Moderately
� Very
� Extremely
� Not at all
� Slightly
� Moderately
� Very
5. How useful will this material be in your work? � Extremely
�
�
6. How would you rate your satisfaction with the �
presenter(s)?
�
�
Very dissatisfied
Somewhat dissatisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
7. Was the venue and content fully accessible
to you?
� Yes
� No (with text box)
8. Would you recommend this
workshop/session to someone else in your
position?
� Yes
� No
9. Employees I interacted with were helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
10. I felt comfortable asking questions.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
11. Did you experience any technical
difficulties? If yes, briefly explain.
� No
� Yes (with text box)
☐ Direct email from a friend/colleague
☐ Email listserv
☐ Flyer
☐ Social media
☐Website
☐Word of mouth
12. How did you hear about this event? (click all ☐ [INSERT OPTION]
that apply)
☐ Other: (open field)
13. What could we improve for next time?
Open Ended
14. Please provide any additional comments
you may have.
Open Ended
Could we contact you if we have any more
questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
Bureau of Consumer Financial Protection
Customer Experience Survey #3
SEFL: General Engagement Survey
Purpose: A general multi-purpose survey for Bureau web and print products, events and
meetings.
Privacy Act Statement
5 U.S.C. 552a(e)(3)
The information you provide through your responses to the Bureau of Consumer Financial
Protection (“Bureau”) will be used to evaluate general engagement of any Supervision,
Enforcement, Fair Lending & Equal Opportunity Division programs.
The Bureau may collect your email address.
Information collected on behalf of the Bureau is treated in accordance with the System of
Records Notice (“SORN”), CFPB.013, https://www.federalregister.gov/articles/2012/09/27/201223756/privacy-act-of-1974-as-amended. Although the Bureau does not anticipate further
disclosing the information provided, it may be disclosed as indicated in the Routine Uses
described in the SORN.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and
1022, codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this survey is voluntary.
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 3170-0024. It expires on 11/30/2018. The time required to complete this
information collection is estimated to average approximately 3 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 Bureau of the Consumer
Financial Protection (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by
email to [email protected].
Goal
Question
Satisfaction
� Extremely Dissatisfied
� Dissatisfied
1. Please rate your OVERALL level of � Neutral
satisfaction with [SERVICE OR
� Satisfied
PROGRAM]?
� Extremely Satisfied
Confidence
Value
2. This [EVENT / PRODUCT /
INTERACTION] increased my
confidence in [SUBJECT MATTER].
3. The purpose of my attending the
event is (check all that apply):
Answer Options
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
☐ [TOPIC / SUBJECT AREA 1]
☐ [TOPIC / SUBJECT AREA 2]
☐ Etc.
☐ Other (Open Ended)
4. My need(s) was / were addressed
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Ease
5. It was easy to complete what I
needed to do.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Efficiency
� Strongly Disagree
� Disagree
� Neutral
6. It took a reasonable amount of time � Agree
to do what I needed to do.
� Strongly Agree
Value
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Equality
7. I was treated fairly.
Inviting
� Strongly Disagree
� Disagree
8. I felt comfortable asking questions. � Neutral
� Agree
� Strongly Agree
� N/A
Employees
9. Employees I interacted with were
helpful.
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
� N/A
Important note about Open-Ended questions:
Please do not share any Personally Identifiable Information (PII), including, but not limited to, your name,
address, phone number, email address, Social Security number, etc.
Technical
10. Did you experience any technical � No
difficulties? If yes, briefly explain.
� Yes (with text box)
� Strongly Disagree
� Disagree
� Neutral
� Agree
� Strongly Agree
Trust
11. I trust the information the Bureau
produces about [TOPIC].
Overall
improvement
12. If we could make one
improvement, what should it be?
Open Ended
Overall
improvement
13. What additional comments do you
have?
Open Ended
Overall
improvement
Could we contact you if we have any
more questions?
� Yes - Please provide your email
____________
� No
Thank you for helping us improve our services.
| File Type | application/pdf |
| Author | Haddadi, Tannaz (CFPB) |
| File Modified | 2019-03-20 |
| File Created | 2019-03-20 |