AR FRG Pilot Client Questionnaire

Approaching Retirement Federal Resource
Guide Pilot: Questionnaire
Instructions:
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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 0985-0081). 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:
a. Healthcare
b. Finances

c. Benefits
d. Other: ________
Please indicate your level of agreement with each of the following statements:
3. The Federal Resource Guide will help me obtain the benefits I need.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree



Completely
Disagree

4. 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

5. 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

6. 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

7. 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

Somewhat
Disagree



Completely
Disagree

8. The information provided in the Federal Resource Guide is clear.


Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



9. 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



Completely
Disagree

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

Completely
Agree



Somewhat
Agree



Neither Agree
nor Disagree



Somewhat
Disagree

11. 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

12. What improvements would you recommend to the Federal Resource Guide?
13. Contact Information:
Name: ____________
Phone: ____________
Email: ____________



Completely
Disagree