Customer Satisfaction of Military Community Support Programs Services-Military OneSource Call Center Counseling

OMB CONTROL NUMBER: 0704-0553

OMB EXPIRATION DATE: 05/31/2025

AGENCY DISCLOSURE NOTICE

The public reporting burden for this collection of information, 0704-0553, is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at [email protected]. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

eCMS Military OneSource Call Center Feedback Form

Military OneSource Health & Wellness Coaching

	Welcome to Military OneSource Feedback! We greatly appreciate your willingness to complete this brief questionnaire to give feedback on the services you received from Military OneSource. Your feedback will help improve the services we provide to our service members and their families. Your participation in this survey is strictly voluntary and your information will not be shared outside of the program office.
*	1. Reason for seeking services (Please select all that apply)
	Life Transition
	Weight Management
	Diet
	Fitness
	Organization
	Living Well with a Health Condition
	Passing Military Physical Readiness Test

*	2. How did you meet with your coach?
	Telephone
	Online Chat
	Video Link

*

3. Please rate the extent to which you agree or disagree with the following statements. Select one response per row.

	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
My coach was knowledgeable in the area of my specific concern.
My coach explained things in a way that was easy to understand.
My coach was attentive to my needs.
My coach understood military culture.

*	4. Thinking about your most recent concern (e.g., diet, weight management), before you connected with Military OneSource, how would you rate the severity of your concern?
	Low
	Moderate
	Severe
	Very Severe
	Don't Know
*	5. Now that you have received services from Military OneSource, how would you rate the severity of this concern now?
	Low
	Moderate
	Severe
	Very Severe
	Don't Know

*	6. Overall Participant Satisfaction Satisfaction – Overall, how satisfied or dissatisfied are you with your experience with Military OneSource? o Very Dissatisfied o Somewhat Dissatisfied o Neither Satisfied nor Dissatisfied o Somewhat Satisfied o Very Satisfied b. Quality - How would you rate the quality of the care that you received? Very low quality Low quality Neither high nor low quality High quality Very high quality Effectiveness - How much do you agree or disagree with the following statement? The service I have received helped me to deal more effectively with my problems. Strongly disagree Disagree Neither agree nor disagree, Agree Strongly agree Recommendation to a friend - How likely is it that you would recommend Military OneSource to a friend or colleague? Very Unlikely Unlikely Not Sure Likely Highly Likely
*	7. How likely are you to reach out to Military OneSource for additional resources or services?
	Very Unlikely
	Unlikely
	Not Sure
	Likely
	Highly Likely

	8. Please tell us anything we should know about your experience with Military OneSource. We appreciate any detail you can provide, especially if our service was less than satisfactory. You will help us to learn and improve. (Please do not share any personally identifying information in your response.)

	Your responses have been registered! Closing Thank you for sharing your feedback. Your responses will help us improve the quality of our programs and services.

Military OneSource Health & Wellness Coaching

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