AR FRG Pilot Questionnaire

ACL Generic Clearance for the Collection of Qualitative Research and Assessment

0080 AR FRG Pilot Client Questionnaire_FINAL Ins 4

Approaching Retirement Life Experience Portfolio: Increasing Access to Decision-Making Support for Older Adults

OMB: 0985-0080

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Approaching Retirement Federal Resource Guide Pilot: Questionnaire



Instructions:

  • You just completed a session with one of our counselors to better understand the benefits available to you as you approach retirement. We are conducting a pilot to improve the Approaching Retirement Federal Resource Guide and would appreciate your feedback on the Guide. Please respond to the questions below to the best of your ability.

  • If you are interested in providing additional detail on your experience with the Approaching Retirement Federal Resource Guide in a short interview, please enter your contact information at the bottom of the questionnaire and someone may contact you.

  • In Person: Once you have completed your questionnaire, please return it to the counselor you met with.

  • Virtual: Once you have completed the questionnaire, please hit “submit.”

  • We will use the feedback from this questionnaire to identify opportunities to improve the Federal Resource Guide. None of the responses will be attributed to specific individuals and all responses will remain confidential.

  • The results from this pilot will be made available at www.performance.gov.

  • Paperwork Reduction Act Public Burden Statement:

According to the Paperwork Reduction Act of 1995 5 CFR § 1320.8(b)(3), no persons are required to respond to a collection of information unless such collection displays a valid OMB control number (OMB 0985-0080).  Public reporting burden for this collection of information is estimated to average 15 minute per response, including time for gathering, maintaining the data needed, completing, and reviewing the collection of information.  The obligation to respond to this collection is voluntary under the statutory authority E.O. 14058, Transforming Federal Customer Experience and Service Delivery to Rebuild Trust in Government. Information collected is planned for use by ACL to: be used internally to ACL to inform the next version of the Approaching Retirement Federal Resource Guide (FRG) and the Federal Forum. The information will not influence any public policy decisions.  ACL uses information collected to improve the content and format of the FRG and the Federal Forum.  Data will be kept private to the extent allowed by law. There are no assurances of confidentiality.

    • Would you like to participate in this questionnaire?

      • Yes (go to first question)

      • No (end the questionnaire)

Questionnaire:

  1. What was the date of your counseling session? _______________________

  2. What was the primary topic(s) of your counseling session? Choose all that apply:

    1. Healthcare

    2. Finances

    3. Benefits

    4. Other: ________

Please indicate your level of agreement with each of the following statements:

  1. The Federal Resource Guide will help me obtain the benefits I need.

  • Completely Agree

  • Somewhat Agree

  • Neither Agree nor Disagree

  • Somewhat Disagree

  • Completely Disagree


  1. The Federal Resource Guide was provided to me at a time that was useful to my decision-making process.

  • Completely Agree

  • Somewhat Agree

  • Neither Agree nor Disagree

  • Somewhat Disagree

  • Completely Disagree


  1. The Federal Resource Guide reduced my level of worry about the financial decisions I need to make.

  • Completely Agree

  • Somewhat Agree

  • Neither Agree nor Disagree

  • Somewhat Disagree

  • Completely Disagree


  1. The Federal Resource Guide reduced my level of worry about the healthcare decisions I need to make.

  • Completely Agree

  • Somewhat Agree

  • Neither Agree nor Disagree

  • Somewhat Disagree

  • Completely Disagree


  1. The Federal Resource Guide made the process of obtaining benefits easier to understand.

  • Completely Agree

  • Somewhat Agree

  • Neither Agree nor Disagree

  • Somewhat Disagree

  • Completely Disagree


  1. The information provided in the Federal Resource Guide is clear.

  • Completely Agree

  • Somewhat Agree

  • Neither Agree nor Disagree

  • Somewhat Disagree

  • Completely Disagree


  1. The information provided in the Federal Resource Guide is comprehensive (i.e., nothing is missing).

  • Completely Agree

  • Somewhat Agree

  • Neither Agree nor Disagree

  • Somewhat Disagree

  • Completely Disagree


  1. The Federal Resource Guide is written in a language I can read and understand.

  • Completely Agree

  • Somewhat Agree

  • Neither Agree nor Disagree

  • Somewhat Disagree

  • Completely Disagree


  1. As a result of the Federal Resource Guide, I know the next step I need to take to obtain benefits.

  • Completely Agree

  • Somewhat Agree

  • Neither Agree nor Disagree

  • Somewhat Disagree

  • Completely Disagree


  1. What improvements would you recommend to the Federal Resource Guide?


  1. Contact Information:

Name: ____________

Phone: ____________

Email: ____________

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorAmy Cowart
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File Created2024-08-05

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