General Engagement Survey

Consumer Financial Protection Bureau
Customer Experience Survey #3
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 Bureau 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/2012/09/27/2012-23756/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 XX/XX/XXXX. 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

Satisfaction

Confidence

Question

Answer Options

1. Please rate your OVERALL level of
satisfaction with [SERVICE OR
PROGRAM]?

Extremely Dissatisfied
Dissatisfied
Neutral
Satisfied
Extremely Satisfied

2. This [EVENT / PRODUCT /
INTERACTION] increased my
confidence in [SUBJECT MATTER].

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

Value

[TOPIC / SUBJECT AREA 1]
[TOPIC / SUBJECT AREA 2]
Etc.
Other (Open Ended)

Value

4. My need(s) was / were addressed

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

5. It was easy to complete what I
needed to do.

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

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

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

7. I was treated fairly.

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

8. I felt comfortable asking questions.

Strongly Disagree
Disagree
Neutral
Agree

3. The purpose of my attending the
event is (check all that apply):

Ease

Efficiency

Equality

Inviting

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.
10. Did you experience any technical
difficulties? If yes, briefly explain.

No
Yes (with text box)

Trust

11. I trust the information the Bureau
produces about [TOPIC].

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree

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?

Technical

Yes - Please provide your email
____________
No

Thank you for helping us improve our services.