Call Center Feedback Form

NHTTAC Consultant and Evaluation Package

2 - Call Center Feedback

Call Center Feedback Form

OMB: 0970-0519

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0970-0519 can be found here:

2023-03-24 - Revision of a currently approved collection

Document [pdf]

Download: pdf | pdf

CALL CENTER

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

FEEDBACK
Form

In order to help the National Human Trafficking Training and Technical Assistance Center (NHTTAC) 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, including reporting all information in aggregate
to avoid identifying information. Only members of the NHTTAC Evaluation Team have access to information that could identify
respondents. If you have any questions about this survey or the evaluation, please contact NHTTACEval@icf.com.
Please provide the information below to create an anonymous ID:

Birth Month
(insert just the month
for your date of birth,
example: 08 for August)

First letter of first name
(example: S for Sara)

First letter of your middle name
(example: M for Maria)

Please indicate the extent to which you agree or disagree with the following statements.

OVERALL ASSISTANCE

Strongly
Disagree
1

Strongly
Agree
4

Not
Applicable
NA

Disagree

Agree

NHTTAC staff was responsive to my questions and needs.

The information/assistance I received was easy for me to
understand.

The information/assistance I received was grounded in
current evidence-based research or promising practices.

The information/assistance I received was traumainformed.

The information/assistance I received was survivorinformed.

The information/assistance I received was grounded in a
multidisciplinary approach to addressing human trafficking.

The information/assistance I received reflected a public
health approach to addressing human trafficking.

The information/assistance I received will help me in my
work.

The information/assistance I received met my professional
needs.

10. The information/assistance I received met my educational
needs.

11. I am satisfied with the information/assistance I received.

12. I will return to NHTTAC staff for my training and technical
assistance needs.

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information
collection is to enable NHTTAC to collect recipient and stakeholder feedback to improve NHTTAC’s T/TA service delivery. Public reporting
burden for this collection of information is estimated to average 0.083 hours per respondent, including the time for reviewing instructions,
gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. An
agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the
Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any comments on this collection of
information, please contact the NHTTAC Evaluation Team at NHTTACEval@icf.com or 9300 Lee Highway, Fairfax, VA 22031.

CALL CENTER

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

FEEDBACK
Form

13. Please rate the overall quality of the assistance you received.
1

Poor

Fair

Good

Excellent

14. How did you first hear about NHTTAC?
□
□
□
□
□

□

The NHTTAC Website
An exhibit or presentation at a conference
A link from another website/Searching the Internet
A colleague or friend
A publication or newsletter

□

My OTIP program monitor or other OTIP staff
person
Other (please specify):

15. How often have you used NHTTAC in the last 12 months?
□
□

□
□

1 – 3 times
4 – 6 times

7 – 9 times
10+ times

16. How did you most recently access NHTTAC? (Mark all that apply.)
□
□
□

NHTTAC Website
Toll-free number for Call Center
OTIP program monitor or other OTIP staff person

□
□
□

Email
TTY
Other (please specify):

17. Why did you use/contact NHTTAC? (Mark all that apply.)
□
□
□
□
□
□
□
□
□
□

Request general information about OTIP or NHTTAC
Obtain a referral for direct services
Access online materials or training
Join the listserv or mailing list
Apply to be a consultant/trainer
Obtain information on services for people who are currently being trafficked, at risk of trafficking, or have been
trafficked.
Acquire help for technical problems on website
Request or apply for assistance:
□ Technical assistance
□ Training
Funding for a conference/event or speaker
Other (please specify):

18. In general, how promptly was your request(s) acknowledged?
□ Within 24 hours
□ Between 24-48 hours

□ Between 3-5 days
□ Between 6-7 days

19. Would you recommend NHTTAC to others to receive T/TA?

□ More than a week
□ My request was not
acknowledged
□ Yes

□ No

CALL CENTER

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

FEEDBACK
Form
20. Do you have any other comments or suggestions?

21. Which of the following best describes the organization in which you work? (Mark all that apply.)
□

Academic institution
Anti-trafficking organization

□

Business/For-profit organization

□
□

Coalition/Multidisciplinary team/Task
force

□
□
□
□
□
□

Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization
OTIP grantee
Self-employed

□
□
□
□
□

Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _

22. Which of the following best describes your professional capacity or types of services you provide? (Mark all that
apply.)

□
□
□
□
□
□
□

Behavioral health professional (e.g., psychologist,
psychiatrist, mental health/substance use counselor)
Child welfare (e.g., state agency staff, child welfare
contractor, nonprofit personnel)
Corrections-based services (e.g., parole, probation)
Criminal justice (e.g., law enforcement, prosecutor,
probation, court, forensic interviewer)
Educator (e.g., teacher, professor, school
administrator)
Health care (e.g., physician, physician assistant,
nurse practitioner, dentist, nurse, pharmacist)
Housing (e.g., case worker, shelter director, public
housing authority agencies)

□
□
□
□
□
□

Legal (e.g., immigration, civil and/or rights-based
attorney and/or paralegal, clinic)
Public health (e.g., licensure board, health
department staff, health care executive, community
health workers)
Social worker (e.g., case manager, school
counselor, supervisor, administrator)
Survivor empowerment, mentoring, or peer to peer
Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_

23. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes

□ No

24. 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

CALL CENTER

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

FEEDBACK
Form
25. Which of the following best describes your primary role in your current position?
□ Direct delivery/frontline staff
□ Management
□ Other (please specify):

□ Consultant/Trainer
□ Volunteer

□ Administration
□ Peer Educator

26. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at risk
of being trafficked, or have been trafficked?
1

Never

Occasionally

Frequently

All the Time

Which of the following best describes your geographic population? (Mark all that apply.)
□ National
□ State (please specify):
□ Tribal
□ International (please specify country):

□

Local
□ Urban
□ Rural
□ Suburban

27. Please select any of the following populations you currently work with in a professional capacity (Mark all that apply.)

□

□
□
□

Human trafficking
□ Commercial sexual exploitation of
children
□ Sex trafficking
□ Adults
□ Minors
□ Labor trafficking
□ Adults
□ Minors
Children/youth
□ Out of home/Foster care/Kinship care
□ Juvenile justice
□ Runaway/Homeless youth
People with disabilities
Deaf/Hearing impaired
Elderly

□
□
□
□

□
□
□
□
□

Lesbian, gay, bisexual, transgender, and
questioning
Foreign nationals (migrant workers, undocumented
immigrants, refugees)
People with low incomes
Racial and ethnic minorities
□ American Indian or Alaska Native
□ Asian
□ Black or African American
□ Native Hawaii or other Pacific Islander
□ White
□ Hispanic or Latino ethnicity
History of substance use
Domestic and dating violence
Gang-related crime
Sexual abuse/Violence
Other (Please specify):

28. What is your race? (Mark all that apply.)

□
□
□
□

American Indian or Alaska Native Asian
Black or African American
Native Hawaii or other Pacific Islander White
Other (please specify):

CALL CENTER
FEEDBACK
Form

OMB Control Number: 0970-0519
Expiration Date: 05/31/2020

29. What is your ethnicity? (Mark all that apply.)

□
□
□

Hispanic or Latino
Middle Eastern or North African
Other (please specify):

30. What is your gender? (Mark all that apply.)

□
□
□
□

Male
Female
Transgender
Other (please specify):

Thank you for taking the time to complete this form and helping to improve NHTTAC activities.

File Type	application/pdf
File Title	2 - Call Center Feedback.docx
Author	Field, Michael
File Modified	2020-03-20
File Created	2020-03-20