Call Center Feedback form

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CALL CENTER

OMB#: 1121-XXXX
Date of Expiration: XXXX

Participant Feedback

We identified you as someone who has recently been in contact with the OVC TTAC Call Center. In order to help OVC TTAC
better serve the field, we are reaching out to obtain your feedback. We will protect the privacy of your information in accordance
with the Federal Privacy Act, and we will protect the confidentiality of your responses using procedures we have in place. Answers
to these questions will be reported after aggregating all responses. Your participation in this survey is completely voluntary. If you
have any questions about this survey or the evaluation, please contact [email protected].
Please indicate the extent to which you agree or disagree with the following statements.

OVERALL ASSISTANCE
1.
2.
3.
4.
5.
6.

OVC TTAC was responsive to my questions and needs.
The information/assistance I received was easy for me to
understand.
The information/assistance I received will help me in my work.
The information/assistance I received met my professional goals.
I am satisfied with the information/assistance I received.
I will return to OVC TTAC for my training and technical assistance
needs.
7.

Strongly
Disagree

Disagree

Neither
Agree nor
Disagree

Agree

Strongly
Agree

Not
Applicable

1

2

3

4

5

NA

1

2

3

4

5

NA

1
1
1

2
2
2

3
3
3

4
4
4

5
5
5

NA
NA
NA

1

2

3

4

5

NA

How did you first hear about OVC TTAC? (Mark one.)
□ OVC TTAC website
□ Exhibit or presentation at a conference
□ Link from another website/Searching the Internet
□ Colleague or friend
□ Publication or newsletter
□ OVC program monitor or other OVC staff person
□ Other (please specify): ________________________________________________________________________________

8.

How often have you used OVC TTAC in the last 12 months? (Mark one.)
□ 1–3 times
□ 4–6 times

9.

□ 7–9 times
□ 10+ times

How did you access OVC TTAC? (Mark all that apply.)
□ OVC TTAC website
□ Toll-free number for Call Center
□ OVC program monitor or other OVC staff person

□ Email
□ TTY
□ Other (please specify): __________________________

10. Why did you use/contact OVC TTAC? (Mark all that apply.)
□ Request general information about OVC or OVC TTAC
□ Obtain general information about victim services
□ Obtain a referral for direct services
□ Access online materials or training
□ Join the listserv or mailing list
□ Apply to be a consultant/trainer
□ Acquire help for technical problems on website

□ Request or apply for assistance:
□ Technical assistance
□ Training
□ Funding for a conference/event or speaker
□ Scholarship
□ National Victim Assistance Academy
□ Other (please specify): __________________________

11. In general, how promptly was your request acknowledged? (Mark one.)
□ Immediately
□ Within 1 day

□ Within 2–3 days
□ Within 1 week

12. Would you recommend OVC TTAC to others?

□ Yes

□ More than 1 week
□ My request was not acknowledged
□ No

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number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the OVC TTAC evaluation team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

CALL CENTER

OMB#: 1121-XXXX
Date of Expiration: XXXX

Participant Feedback
13. What did you find most helpful about OVC TTAC’s resources?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
14. What could be done differently to improve your experience with OVC TTAC?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
15. Do you have any other comments or suggestions?

____________________________________________________________________________________
____________________________________________________________________________________
16. Which of the following best describes your gender identity? (Mark one.)
□ Male
□ Female
□ Transgender Male

□ Transgender Female
□ Genderqueer/NonConforming/
Non-Binary

□ Two-Spirit
□ Not Listed (option to specify):
_________________________

17. Which of the following best describes your race/ethnicity? (Mark all that apply.)
□ American Indian or Alaska Native
□ Asian
□ Black/African American
□ Hispanic/Latino

□ Native Hawaiian or
Pacific Islander
□ White Non-Latino or
Caucasian

□ Not Listed (option to specify):
_________________________

18. Which of the following best describes the organization in which you work? (Mark all that apply.)
□ Community-Based/Grassroots
□ Criminal Justice Agency
□ Education
□ Faith-Based

□ Health/Mental Health Services
□ Human/Social Services
□ Legal Services
□ Legislation/Policymaking

□ Military
□ Research
□ Other (please specify):
_________________________

19. Which types of victim services do you provide for crime victims in your current position? (Mark all that apply.)
□ I do not provide direct services
□ Child Care
□ Compensation/Restitution
□ Counseling
□ Crisis Intervention

□ Criminal Justice System
Advocacy/Assistance
□ Housing/Shelter
□ Information/Referral
□ Medical/SANE/SART

□ Notification
□ Transportation
□ 24-Hour Hotline
□ Other (please specify):
_________________________

20. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years

□ 3 to 5 years

□ 6 to 10 years

□ More than 10 years

21. Which of the following best describes your primary role in your current position? (Mark all that apply.)
□ Direct Delivery/Front Line Staff
□ Management/Administrative Staff

□ Consultant/Trainer
□ Volunteer

□ Other (please specify):
_________________________

22. Which of the following best describes the population you serve? (Mark all that apply.)
□ National
□ State
□ Tribal
□ International, list country:
_________________________________

□ Local
□ Urban
□ Rural
□ Suburban

23. Please provide your city and state (i.e., location of organization or professional address).

___________________________________________________________________________________

CALL CENTER
Participant Feedback

OMB#: 1121-XXXX
Date of Expiration: XXXX

24. Please list any marginalized or underserved populations you serve.

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Thank you for taking the time to complete this form and helping to improve OVC TTAC activities.