DEEOIC Resource Center Customer Service Survey

DIVISION OF ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION (DEEOIC)
OFFICE OF WORKERS’ COMPENSATION PROGRAMS
UNITED STATES DEPARTMENT OF LABOR

Resource Center Customer Experience Survey
Which Resource Center did you visit today?
___ California

___Denver

___Espanola

___Hanford

___Idaho

___Las Vegas

___New York

___Oak Ridge

___Paducah

___Portsmouth

___Savannah River

Please indicate the reason for your visit today.
___Filing a claim

___Completing an Occupational History Questionnaire interview

___Status of your claim

___Submitting documents

___General program information

___Other:_________________________________________________

___Medical bill payment assistance

Please indicate your answers to the
statements below by circling a response.

Strongly
Agree

Agree

Neutral

Disagree

I am satisfied with the service I received at the
Resource Center today.

5

4

3

2

1

n/a

This interaction increased my trust in DEEOIC.

5

4

3

2

1

n/a

My need was addressed at the Resource Center
today.

5

4

3

2

1

n/a

It was easy to complete what I needed to do at
the Resource Center today.

5

4

3

2

1

n/a

My Resource Center visit took a reasonable
amount of time.

5

4

3

2

1

n/a

I was treated fairly today.

5

4

3

2

1

n/a

Employees I interacted with today were helpful.

5

4

3

2

1

n/a

If your questions/issues were not resolved, did
the employee provide a date when you could
expect a follow-up contact?

yes

no

n/a

Strongly
Disagree N/A

Additional feedback (please continue on the back of this form if necessary):

The OMB control number for this collection is 1225-0093 and expires on 02/29/2024. According to the Paperwork Reduction Act of 1995, no person is
required to respond to a collection of information unless such collection displays a valid OMB control number. The obligation to respond to this collection is
voluntary. We estimate it takes about 5 minutes to complete this collection of information, including time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing the collection of information. Please send comments regarding the burden estimate or any
other aspect of this collection of information to the U.S. Department of Labor, DEEOIC, 200 Constitution Ave., NW, Room C-3321, Washington, D.C. 20210
and reference OMB Control Number 1225-0093.
OMB Control Number: 1225-0093
Note: Please do not return the completed form to this address.