Generic Clearance for NCA, and IG Customer Satisfaction Surveys

OMB APPROVAL NO. 2900-0571

U.S. DEPARTMENT OF VETERANS AFFAIRS
NATIONAL CEMETERY ADMINISTRATION

NATIONAL CEMETERIES:
2006 SATISFACTION SURVEY

Please read and answer the following question first.
Have you visited a national cemetery in the past 12 months?
No (STOP. You do not have to complete the rest of this questionnaire, but please return the
questionnaire in the enclosed postage-paid envelope.)
Yes (Continue on to the next question.)

OMB Control Number 2900-0571
Public Reporting Burden Statement
VA may not conduct, sponsor, or require the respondent to respond to this collection of information unless it displays a valid OMB Control Number.
All responses to this collection are voluntary. Public reporting burden for this collection of information is estimated to average 20 minutes per
response, including the time necessary for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. The information collected is intended to be used in making improvements in services
within the National Cemetery Administration of the Department of Veterans Affairs and for associated administrative purposes. Failure to furnish
the requested information will have no adverse effect on any VA benefit to which you may be entitled.
The information you supply will be confidential and protected by the Privacy Act of 1974 (5 U.S.C. 522a) and the VA's confidentiality statute (38
U.S.C. 5701) as implemented by 38 CFR 1.526(a) and 38 CFR 1.576(b). Disclosure of information involves releases of statistical data and other
non-identifying data for the improvement of services within the National Cemetery Administration and for associated administrative purposes.
Please send any comments regarding this burden estimate or any other aspect of this collection, including suggestions for reducing this burden to
VA Clearance Officer (005G2), 810 Vermont Ave., NW, Washington DC 20420. SEND COMMENTS ONLY. DO NOT SEND THIS FORM OR
REQUESTS FOR BENEFITS TO THIS ADDRESS.

DO NOT WRITE IN THIS AREA

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Marking Instructions
The survey will take about 20 minutes to complete.
Please read each question carefully and respond by filling in the
oval of the response that most closely represents your opinion.

Correct Mark

Incorrect Marks

• Use pencil or pen. Make heavy dark marks that fill the ovals completely. If you wish to change an answer, erase cleanly
(pencil), or put an "X" over the incorrect response (pen).

• Fill in one answer oval for each question unless it tells you to "mark all that apply".
• When you are finished, please place the questionnaire in the enclosed postage-paid envelope and put it in the mail.
Next-of-Kin: Respond to the questions on the left column of the page, beginning with Question 1.
Funeral Directors: Respond to the questions on the right column of the page, beginning with Question A.

Questions for Next-of-Kin

Questions for Funeral Directors
A. Looking at the attached form, please identify
the national cemetery with which you most
frequently do business and fill in the
corresponding number in the spaces below.
Please complete this survey based on your
experiences at this national cemetery within
the past 12 months.

Please complete this survey based on your
experiences at the national cemetery where
your loved one was interred.
1. Since the committal service, how many times
have you visited the national cemetery where
your loved one was interred?
1-3
4-6
7-9
10 or more
None, I have not visited
2. Your recently deceased loved one was your...
Spouse
Parent
Brother/Sister
Son/Daughter (includes stepchildren)
Other relative
Friend
3. What burial option was chosen for your
loved one?
In ground (full casket)
Cremation - in ground
Cremation - columbarium
Don't know

0

0

0

1

1

1

2

2

2

3

3

3

4

4

4

5

5

5

6

6

6

7

7

7

8

8

8

9

9

9

B. How far is your funeral home from the
national cemetery with which you most
frequently do business?
Less than 15 miles
15 to 30 miles
30 to 45 miles
45 to 60 miles
60 to 75 miles
Over 75 miles

4. How far do you reside from the national
cemetery?
Less than 15 miles
15 to 30 miles
30 to 45 miles
45 to 60 miles
60 to 75 miles
Over 75 miles

C. How long has your funeral home worked
with the national cemetery?
Less than 1 year
1 to 4 years
5 to 8 years
9 to 12 years
13 years or more
Don't know

5. Does the distance to the cemetery limit the
number of times you visit?
Yes
No

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Next-of-Kin: Respond to the questions on the left column of the page.
Funeral Directors: Respond to the questions on the right column of the page.

Questions for Next-of-Kin

Questions for Funeral Directors

6. Are you a veteran or a current member of
the active military or the reserve?
Yes
No

D. Of the eligible veteran families you serve,
approximately what percent choose burial
in the national cemetery?
1-5 %
5-10%
10-15%
15-25%
25-50%
50-75%
75-100%

7. Prior to your time of need, to what extent
were you aware of the benefits related to
burial in a national cemetery?
Completely aware
Somewhat aware
Unaware (SKIP to Q9)

E. How would you characterize the overall
communication from the national cemetery
to your funeral home?
Excellent
Good
Fair
Poor

8. How did you learn of these benefits prior to
your time of need? (Mark all that apply)
Family member/friend is buried there
Family member
Funeral home
Military discharge-related materials
Other veteran/active duty member
Friend
VA/NCA pamphlet, brochure, newsletter
VA/NCA Web site
Veterans Service Organization
State/County Veteran Service Officer
Other VA organization
Local newspaper/television news reports
Public events (e.g., parades, exhibits,
speeches)
Professional/military association meetings
or conventions

F. Do you feel that you are well informed by
the national cemetery of its policies and
procedures?
Yes, well informed
Yes, somewhat well informed
No, not well informed

9. Prior to the time of need, what is the BEST
way for the national cemetery to convey
information regarding benefits? (Mark only one)
E-mail
VA/NCA Web site
Newsletter/flyer
Local newspaper/television news reports
Public events (e.g., parades, exhibits,
speeches)
Professional/military association meetings
or conventions
Other
10. To what extent were you informed of the
details (e.g., length of service, use of
committal shelters) related to the committal
service prior to attending the service?
Very informed
Somewhat informed
Neither informed nor uninformed
Somewhat uninformed
Very uninformed
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G. In general, of the following services, which
one provides you the MOST information
about national cemetery policies and
procedures? (Mark only one)
VA/NCA Web site
Local newspaper/television news reports
Public events (e.g., parades, exhibits,
speeches)
Professional associations/conventions/
meetings
Veterans Service Officers
Outreach by cemetery staff
Other

Next-of-Kin: Respond to the questions on the left column of the page.
Funeral Directors: Respond to the questions on the right column of the page.

Questions for Next-of-Kin

Questions for Funeral Directors
H. What national cemetery policies or
procedures do you feel you could use more
information about? (Mark all that apply)
None, I feel well informed
Eligibility requirements for burial in a
national cemetery
Scheduling process
Military funeral honors
Presidential Memorial Certificates
Floral policy
Headstone, marker, or columbarium
niche cover inscription options

11. Overall, how satisfied are you with the
information you were provided throughout
your experiences with the national cemetery?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied
12. At the committal service, did your family
have any of the following special needs or
requests? (Mark all that apply)
Visit the gravesite
View the burial
Special music
Special religious practices (e.g., blessing
the gravesite)
Additional seating at the committal service
Handicapped accommodations
No, my family did not have any special
needs or requests (SKIP to Q14)

I. What is the best way for the national
cemetery to communicate with your funeral
home regarding changes in its policies and
procedures? (Mark only one)
Phone
Fax
Letter
Email
VA/NCA Web site
Newsletter or flyer

13. Was the cemetery able to accommodate
these special needs or requests to your
satisfaction?
Yes, completely
Yes, somewhat
No, and I understand why
No, and I did not understand why

J. Overall, how satisfied are you with the
communication between your funeral home
and the national cemetery?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied

14. If your loved one was a veteran, did your
family request military funeral honors?
Yes, and honors were provided
Yes, but honors were not provided
(SKIP TO Q17)
No, did not request military funeral honors
(SKIP TO Q17)
(If your loved one was NOT a veteran, please
SKIP TO Q17)
15. Who provided military funeral honors?
Active duty honor guard
Reserve unit honor guard
National Guard honor guard
Volunteer honor guard (Veteran Service
Organizations)
Not sure/don't know

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Next-of-Kin: Respond to the questions on the left column of the page.
Funeral Directors: Respond to the questions on the right column of the page.

Questions for Next-of-Kin

Questions for Funeral Directors

16. How satisfied were you with the quality of the
military funeral honors your loved one received?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied
17. Overall, how satisfied were you with the
committal service at the national cemetery?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied

K. Overall, how would you compare the level
of service you receive from the national
cemetery with the level of service you
receive from private cemeteries?
Superior to private cemeteries
Better than private cemeteries
About the same
Worse than private cemeteries
Much worse than private cemeteries
Don't know/not applicable
L. To what extent do you understand the
eligibility requirements for burial in a
national cemetery, including eligibility for
reservists and veteran dependents?
Understand completely
Understand somewhat
Do not understand

18. Were the headstone, marker, or columbarium
niche cover inscription options explained
to you?
Yes
No (SKIP TO Q22)
Not sure/don’t know (SKIP TO Q22)

M. How well do you understand the headstone,
marker, or columbarium niche cover
inscription options available to next of kin?
Understand completely
Understand somewhat
Do not understand

19. Which of the following inscription options
were explained to you? (Mark all that apply)
Military service information (e.g., rank,
service, valor awards)
Emblems of belief
Terms of endearment (e.g., beloved father)

N. How easy is the process of scheduling an
interment with the national cemetery?
Very easy
Somewhat easy
Neither easy nor hard
Somewhat hard
Very hard

20. Did you feel you had sufficient time to make
a decision on the headstone, marker, or
columbarium niche cover inscription
options?
Yes
No
21. Who explained headstone, marker, or
columbarium niche cover inscription options
to you?
National cemetery representative ONLY
Funeral director ONLY
BOTH the national cemetery representative
and the funeral director
NEITHER the national cemetery
representative nor the funeral director

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Next-of-Kin: Respond to the questions on the left column of the page.
Funeral Directors: Respond to the questions on the right column of the page.

Questions for Next-of-Kin

Questions for Funeral Directors

22. Is the permanent marker, headstone, or
columbarium niche cover currently in place?
Yes
No, the marker or headstone has not yet
arrived (SKIP TO Q27)
Don’t know (SKIP TO Q27)

O. How long does it typically take to confirm
the scheduling of an interment at the
national cemetery?
Less than 1 hour
1 to 2 hours
2 to 4 hours
4 to 8 hours
1 to 2 days
More than 2 days

23. How satisfied were you with the length of
time it took for the permanent headstone,
marker, or columbarium niche cover to be
in place?

P. During committal services, how often do
you receive the support you need from
cemetery staff?
Always
For the most part
Occasionally
Never

Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied
24. When the headstone, marker, or
columbarium niche cover arrived, was
the inscription accurate?
Yes
No
Don't know

Q. Generally, how often do committal services
at the national cemetery start on time?
Always
For the most part
Occasionally
Never

25. Overall, how satisfied were you with the
quality and appearance of the headstone,
marker, or columbarium niche cover when
it arrived?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied

R. If you are delayed in arriving at the national
cemetery for a scheduled service, how
successful is the cemetery in adjusting the
schedule to accommodate the family?
Very successful
Somewhat successful
Neither successful nor unsuccessful
Somewhat unsuccessful
Very unsuccessful
Don't know/Not applicable

26. If your loved one was interred in a
columbarium, how satisfied are you that the
quality and design of the columbaria are
compatible with the overall appearance of
the cemetery?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied
27. If your loved one was a veteran, did you
receive a Presidential Memorial Certificate?
No
Yes
(If your loved one was NOT a veteran, please
SKIP TO Q28)

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Next-of-Kin: Respond to the questions on the left column of the page.
Funeral Directors: Respond to the questions on the right column of the page.

Questions for Next-of-Kin

Questions for Funeral Directors

28. Looking back at your overall experiences
with the national cemetery, which items
would you have liked more information
about? (Mark all that apply)
None, I was well informed
Details of the committal service
Military funeral honors
Location of gravesite
Layout of cemetery (maps)
Directions to cemetery
Presidential Memorial Certificate
Floral policy
Headstone or marker inscription options
Timeline for placement of headstone/marker

S. How easy is it to schedule military honors
at the national cemetery?
Very easy
Somewhat easy
Neither easy nor hard
Somewhat hard
Very hard
T. To what extent is the quality of military
honors acceptable?

Please indicate your level of agreement with
the following statements.
a. The maintenance of the cemetery grounds is excellent. . . . . . . . . . . . .
b. The upkeep of the headstones, markers, or columbarium niche
covers is excellent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c. The maintenance of other landscape features (e.g., flowers,
trees, shrubs) is excellent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. The committal shelter used for the service was clean, free of
safety hazards, and private. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
e. There is adequate handicap accessibility for visitors who need it. . .
f. The availability of restrooms is suitable to accommodate
visitors on busy days. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g. The cemetery honors all veterans and their service to our nation. . .
h. There are sufficient signs within the cemetery to assist visitors. . . .
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Neither
a
nor disa gree
gree
Disagre
e
Strongly
disagre
e
Don't kn
Not app ow/
licable

Strongly

Questions for All Participants

Agree

29. Overall, what was the biggest contributing
factor to the decision to bury your loved
one in a national cemetery? (Mark only one)
Honor the wishes of my loved one
Recognition of military service
Other family member also buried at
national cemetery
Location
Affordability

agree

Very acceptable
Somewhat acceptable
Neither acceptable nor unacceptable
Somewhat unacceptable
Very unacceptable

Neither
a
nor disa gree
gree
Disagre
e
Strongly
disagre
e
Don't kn
Not app ow/
licable

Agree

i. Parking at the cemetery is adequate to accommodate visitors
on most days. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

agree

Please indicate your level of agreement with
the following statements.

Strongly

Questions for All Participants (continued)

j. The cemetery's roadways and intersections are safe and
easily navigated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
k. The quality of service received from cemetery staff is excellent. . . .
l. The national cemetery hours of operation meet my needs. . . . . . . . . .
m. The appearance of my loved one's gravesite/columbaria is
excellent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
n. The information kiosks (i.e., gravesite locators) are helpful to me. . .
o. Public ceremonies and events at the cemetery promote a sense
of patriotism and heritage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
p. The overall appearance of the national cemetery is excellent. . . . . .
q. Overall, I am satisfied with my experiences at the national
cemetery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
r. I would recommend the cemetery to veteran families during
their time of need. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
s. I am willing to rely on VA and the National Cemetery Administration
to meet the burial needs of veterans in the future. . . . . . . . . . . . . . . . . . .
t. I am willing to rely on VA and the National Cemetery
Administration to maintain national cemeteries as national
shrines in the future. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
u. My experiences with the national cemetery exceeded my expectations. .
General Comments: Please use this space to elaborate on any aspect of your experiences at the national
cemetery you wish to share with us.

Thank you for taking the time to complete this survey. Your answers are very important to ensure that the services provided
by national cemeteries meet your needs and expectations. Please return your questionnaire in the postage-paid envelope.

DO NOT WRITE IN THIS AREA

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R23230-PFI-54321