AR Federal Forum Pilot Questionnaire

Approaching Retirement Federal Forum on
Serving Older Adults: Questionnaire
Instructions:
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You just completed a Federal Forum on Serving Older Adults (“Federal Forum”) to better
understand the benefits available to your clients as they approach retirement. We are
conducting a pilot to improve the Federal Forum and would appreciate your feedback on the
session. Please respond to the questions below to the best of your ability.
We will use the feedback from this questionnaire to identify opportunities to improve the
Federal Forum. 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 0985-0081). Public reporting burden for this collection of information is
estimated to average 15 minutes 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 the Federal Forum? _______________________
Please indicate your level of agreement with each of the following statements:
2. The Federal Forum increased my knowledge of the federal and local benefits and services available
for my clients as they make financial and healthcare decisions.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree



Completely
Disagree

3. The Federal Forum increased my access to materials and tools that will assist my clients as they make
financial and healthcare decisions.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree



Completely
Disagree

4. I now have a better understanding of the federal programs and benefits available to my clients as
they make financial and healthcare decisions.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree



Completely
Disagree

5. The Federal Forum reduced my level of worry about helping my clients make financial and
healthcare decisions.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree



Completely
Disagree

6. The Federal Forum will reduce the time it takes me to navigate federal resources that help my clients
make financial and healthcare decisions.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree



Completely
Disagree



Completely
Disagree

7. The information provided during the Federal Forum was easy to understand.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree

8. The information provided about the topic(s) covered during the Federal Forum was thorough.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree



Completely
Disagree

9. As a result of the Federal Forum, I am better positioned to help my clients as they make financial and
healthcare decisions.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree

10. What additional topics would you like to see covered during the Federal Forum?
11. What improvements would you recommend to the Federal Forum?



Completely
Disagree