COMMUNICATION AND PROCESS SURVEY
FEMA Form 007-0-9
OMB Control Number 1660-0036
Expiration ___
Public reporting burden for this survey is estimated to average 15 minutes per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting the survey. You are not required to respond to this collection of information unless it displays a valid OMB control number near the title of the electronic collection instrument, or for on-line applications, on the first screen viewed by the respondents. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (1660-0036) NOTE: Do not send your completed form to this address.
The following survey is voluntary.
Hello, I’m calling from FEMA, the Federal Emergency Management Agency. My name is ________. My I.D. # is _______. May I please speak with ____________________(applicant name) or the person who handled your FEMA application?
If no: Thank you for your time and have a good day/evening. (Mark Attempt)
If yes: We’re looking for ways to improve the quality of our service and your opinion is very important to us. Would you volunteer to take 5-8 minutes to answer some questions?
If yes: Thank you. The following questions have been approved by the Office of Management and Budget under number 1660-0036. Please be assured your answers will not affect the outcome of your application for FEMA assistance.
If No: I understand. Thank you for your time and have a nice day/evening. |
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COMMUNICATIONS |
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Now, I would like you to consider the many ways you may have become aware of FEMA disaster assistance. |
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Response Options |
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ComQ1. What were your main sources of FEMA disaster assistance information?
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COMMUNICATIONS (Continued) |
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Response Options |
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Com2. How would you rate each communication source mentioned [insert sources] on providing the information you needed? Would you say it was…
(Select source checked and repeat if multiple sources.)
(READ scale only as needed) |
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COMMUNICATIONS (Continued) |
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Response Options |
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ComQ3. When did you first hear that you could apply for FEMA disaster assistance?
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COMMUNICATIONS (Continued) |
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Best Way To Contact |
Response Options |
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ComQ4. What would be the best way for FEMA to provide general disaster assistance information to you after a disaster?
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ComQ4a. What suggestions do you have to improve FEMA’s communication?_________________________________________
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REGISTRATION COMPONENTS – by phone |
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This next series of questions is about registering for disaster assistance. |
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REGISTRATION PROCESS - Overall Rating |
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RI5k |
Overall, what would be your rating of the registration process? Would you say it was … (READ scale) (If Below Average/Poor go to RI5L, otherwise go to RI5m) |
Excellent |
Good |
Satisfactory |
Below Average |
Poor |
Don’t Know/ No Opinion |
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RI5L |
What exactly were you dissatisfied with during the registration process? |
RI5m. What suggestions would you recommend to improve the registration process?_________________________________________
_________________________________________________________________________________________________________
(Clarify)
FINAL WEEK Registration – Phone or Internet (only for those who registered in the last two weeks of the application period) |
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Question |
Response Options |
For this next question, FEMA is looking for new ways to speed up the process of providing disaster assistance. |
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FWR.Q6. What was the primary reason your registration was submitted just before the closing date?
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(DO NOT read)
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On-Line Registration Attempt (Skip if internet registration) |
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These next questions are about attempting to use a mobile device or a computer to register for disaster assistance.
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IntRIQ7. Did you personally try to register using the fema.gov site with a mobile device?
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(DO NOT read)
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Q7-1a. What were your reasons for not using a mobile device to register?
Skip to Q7-2a (Online Computer) |
Other (specify) |
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Q7-2a Have you tried to register online using a computer? |
(DO NOT read) Don’t remember (Skip to next series) |
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IntRIQ7-2b. What were your reasons for not registering online?
Skip to next series |
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IntRIQ7-2c. Why were you unable to register online?
Skip to next series |
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AGENCY REFERRALS |
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When you registered with FEMA, we may have advised you to contact other government agencies or relief organizations that also provide assistance. |
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AgRef7. Were you referred to other agencies? |
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AgRef7a. Which agencies were you referred to?
(Check highlighted agencies that respondent can recall. Blue indicates NEMIS referral.)
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REFERRED AGENCIES (HIGHLIGHTED AGENCIES WERE REFERRED)
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RECALL REFERRAL |
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Small Business Administration |
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American Red Cross |
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Internal Revenue Service |
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Social Security Administration |
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Disaster Unemployment |
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Crisis Counseling |
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Department of Education (Student Loans) |
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Veterans Administration |
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211
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Other |
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Auto Dialer Feature |
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The auto dialer is an electronic feature FEMA uses to let you know that we have received your fax, letter or returned mail. It may also be used to let you know when we sent out a letter, so you can be expecting it in the mail. |
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Question |
Response Options |
If auto populated, go to AD#1b Campaign: _______ Date:____________ received Auto Dialer Message |
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Did you receive a call from FEMA’s automated system?
If yes, go to AD#1a. If No or Do not remember, go to next series. |
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(AD#1a Ask only if the information is not available via auto dialer). AD#1a. What document did the recording refer to?
(DO NOT read list. Mark all that apply.)
Continue to AD#1b if 3,4, 5 selected;
Otherwise, continue to AD#1c:
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If 3) or 4) or 5) from AD#1a, ask:
AD#1b. Did you receive the automated message before you received your letter in the mail? |
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AD#1c. How many times did you receive the same message? |
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AD#1ca. Was that the right number of times for you? If not, what # would have been better? Specify: Text Box |
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CUSTOM QUESTIONS – Auto Dialer Feature |
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AD#1d Was the time of day you received the recording convenient for you? If no, go to AD #1da. If Yes or Don’t Know, go to AD#1e |
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AD#1da What time of day did you receive the recording? |
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AD#1e. How helpful was the information provided on that recorded message? Read list.)
(If Not very helpful or Not at all helpful, go to AD#1ea) |
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AD#1ea. In what way was it not helpful?
(DO NOT read list. Mark all that apply.) |
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AD#1f. Did you need to call the FEMA Helpline after you heard the recording? If yes, go to AD#1fa If no, or do not remember, go to AD#1h. |
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AD#1fa. What help did you need?
(DO NOT read list. Mark all that apply.) |
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CUSTOM QUESTIONS – Auto Dialer Feature |
Continued |
AD#1g. Was the HL representative knowledgeable about the recorded message you received? |
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AD#1h. What suggestions do you have to improve this recorded message feature? [Specify: Text box] |
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SUGGESTION |
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Question |
Response Options |
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Sug: FEMA is interested in getting your opinion on what we could do to improve our service. What other suggestions would you like to pass on to FEMA about improved communications that you haven’t already shared? |
Open-ended Question Type response in designated area. ________________________________________________________________________________________________________________________________________________________ |
PERMISSION AND CLOSING |
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Your opinion is very valuable to us, may we call you at a later date to ask you some additional questions?
If “yes,” Thank you very much for your time. Have a good day/evening. If “No,” I understand. Thank you very much for your time. Have a good day/evening
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FEMA
Form 007-0-9
File Type | application/msword |
File Title | Communication Survey |
Author | Brad Durtschi |
Last Modified By | mbilling |
File Modified | 2011-01-20 |
File Created | 2010-12-09 |