White
House Hotline Survey
OMB Number: 2900-0770
Expiration: 09/30/2020
Estimated Burden: 1 minute
Tell us about the phone call you had with the White House Hotline on <date>.
Please respond to the following statements on a scale of 1 (Strongly Disagree) to 5 (Strongly Agree).
The White House VA Veterans call center representative was prepared to help me. (*Required)
My issue was addressed in a reasonable amount of time.
The VA staff who handled the complaint provided the information in a way that I understood. (*Required)
The VA staff who handled the complaint was courteous and respectful. (*Required)
I trust the VA call center to meet my needs. (*Required)
Thank you. What went well? What went wrong? Please share any additional feedback about your phone call to the White House Hotline. Please do not include any personally identifiable information, Social Security Number, Veteran ID, or medical information, but do provide details about your experience.
❐ Please check this box if you would like to volunteer your demographic information to help VA better serve you, otherwise just click “Next” to submit your survey.
[Next]
The Veterans Crisis Line provides free, confidential support for Veterans in crisis and their families and friends. Dial 1 (800) 273-8255 (Press 1), or text 838255 to receive confidential support 24/7. Visit veteranscrisisline.net for more information.
We are asking for this information so that you can provide compliments, comments, or concerns to VA. Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of one minute to review the instructions and complete this form. VA cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at www.reginfo.gov/public/do/PRAMain.
U.S. Department
of Veterans Affairs
Survey
Support | Privacy Policy
<Headline>Help VA Improve its Services</Headline>
We are working to better understand our customers. The following question is voluntary. By providing your data, your responses can help us improve VA care and services. Thank you for your participation.
Are you Hispanic or Latino?
🔘 Yes
🔘 No
What is your
race? Please choose one or more.
White
Hispanic
Black or African American
Asian
Native Hawaiian or other Pacific Islander
American Indian or Alaska Native
[Submit]
Page
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Newman, Jane E., VBAOAKL |
File Modified | 0000-00-00 |
File Created | 2021-01-21 |