VRE CH31 - Complet VRE CH31 - Completing VR&E Survey Wireframes

Clearance for A-11 Section 280 Improving Customer Experience Information Collection

VRE CH31 - Completing VR&E Survey Wireframes

OMB: 2900-0876

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VR&E Chapter 31
V19 DRAFT <11/04/2022>
Working Draft, Pre-Decisional, Deliberative document – Internal VA Use Only

The VA provides free, confidential support 24/7 for Veterans and their family and
friends. If you are in crisis, contact the Veterans Crisis Line: Dial 988 (Press 1) or
1 (800) 273-8255 (Press 1), text 838255, or visit https://www.veteranscrisisline.net.
If you are homeless or at risk of homelessness, contact the National Call Center
for Homeless Veterans (NCCHV) by dialing 1 (877) 424-3838 or visiting https://
www.va.gov/HOMELESS/.

OMB Number: 2900-0876
Expiration: 03/31/2023
Estimated Burden: 5 Minutes

Help us serve you better.
We want to hear about your experience completing the Veteran
Readiness & Employment (VR&E) Program, also known as Chapter 31.
By responding to this survey, you will directly help us improve the
program and provide better support to Veterans like you. Your ability to
become employed and live independently is important to us!
This survey should take approximately 5 minutes to complete.

I was well prepared to get a job by the education and/or vocational training I received
through VR&E
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

The resume development skills I learned through VR&E were helpful in getting a job
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

The job leads I received were helpful in getting a job
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

The services I received through VR&E were thorough enough to find a job
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

My counselor gave me the opportunity to actively participate in choosing my career
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

My counselor was very helpful in getting me a job
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

My counselor encouraged me to actively participate in reaching my VR&E goals
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

The independent living services I received prepared me to live as independently as
possible
Strongly
Disagree

Disagree

Niether Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

VR&E helped me get appropriate disability accommodations while I participated in training
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

I received appropriate disability accommodations when I got my job
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

All of the needs identified in my plan were met before my case was officially closed
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Not Applicable
(N/A)

What additional services did you need before your case was closed? Do not answer
this question if none were needed. Otherwise, select all services that were needed.
Healthcare referrals
Job leads
More counseling
Training/Apprenticeships/On-the-job training
Certifications

To what extent has VR&E had a positive impact on my mental health
No
Extent

Little
Extent

Moderate
Extent

Good
Extent

Great
Extent

1

2

3

4

5

To what extent has getting suitable employment had a positive impact on my quality
of life
No
Extent

Little
Extent

1

2

Moderate
Extent
3

Good
Extent
4

Great
Extent
5

I trust VR&E to help me prepare for, obtain, and maintain suitable employment or achieve
independence in daily living. Required
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Finish

By filling out this survey, you are authorizing VA database access to retrieve Veteran contact information to follow up with
you accordingly for purposes of service recovery, potential crisis, or to learn more about feedback you have shared
regarding your experience with VA. VA may utilize individual Veteran survey data from this survey or other sources to ensure
the final scores truly and accurately represent the experiences of Veterans. This information is collected in accordance with
section 3507 of the Paperwork Reduction Act of 1995. Title 38, United States Code, allows us to ask for this information. We
estimate that you will need an average of 5 minutes to review the instructions and complete this survey. The results of this
survey will be used to inform opportunities for program improvement in the quality of VA services. Participation in this survey
is voluntary, and your decision not to respond will have no impact on VA benefits or services which you may currently be
receiving. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You
are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be
located on the OMB Internet Page at https://www.reginfo.gov/public/do/PRAMain. Information gathered will be kept private
to the extent provided by law.

Privacy Policy

VR&E Chapter 31
V19 DRAFT <11/04/2022>
Working Draft, Pre-Decisional, Deliberative document – Internal VA Use Only

The VA provides free, confidential support 24/7 for Veterans and their family and
friends. If you are in crisis, contact the Veterans Crisis Line: Dial 988 (Press 1) or
1 (800) 273-8255 (Press 1), text 838255, or visit https://www.veteranscrisisline.net.
If you are homeless or at risk of homelessness, contact the National Call Center
for Homeless Veterans (NCCHV) by dialing 1 (877) 424-3838 or visiting https://
www.va.gov/HOMELESS/.

OMB Number: 2900-0876
Expiration: 03/31/2023
Estimated Burden: 5 Minutes

Thank you for choosing VA.
The U.S. Department of Veterans Affairs uses these surveys to collect
your feedback in order to continuously improve your experience with VA
services.
Please visit VA.gov to explore benefits, resources, and information
at VA.

By filling out this survey, you are authorizing VA database access to retrieve Veteran contact information to follow up with
you accordingly for purposes of service recovery, potential crisis, or to learn more about feedback you have shared
regarding your experience with VA. VA may utilize individual Veteran survey data from this survey or other sources to ensure
the final scores truly and accurately represent the experiences of Veterans. This information is collected in accordance with
section 3507 of the Paperwork Reduction Act of 1995. Title 38, United States Code, allows us to ask for this information. We
estimate that you will need an average of 5 minutes to review the instructions and complete this survey. The results of this
survey will be used to inform opportunities for program improvement in the quality of VA services. Participation in this survey
is voluntary, and your decision not to respond will have no impact on VA benefits or services which you may currently be
receiving. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are
not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be
located on the OMB Internet Page at https://www.reginfo.gov/public/do/PRAMain. Information gathered will be kept private
to the extent provided by law.

Privacy Policy


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