Form 2900-0876-AB1 Financial Services Center Vendor Support Survey Wirefram

FSC_VENDOR SUPPORT
V7.2 DRAFT 11/16/20
Working Draft, Pre-Decisional, Deliberative document – Internal VA Use Only

OMB Number: 2900-0876
Expiration: 03/31/2023
Estimated Burden: 3 minutes

Help us serve you better.
We want to hear about your recent experience with the Financial
Services Center’s (FSC) Vendor Support. Quality customer service is a
priority to us and your feedback directly helps us improve FSC services.
Your participation in this survey is voluntary and you may stop at any
time. Your responses will remain confidential.
This survey should take approximately 3 Minutes to complete.
It was easy to contact Vendor Support. Required
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

The representative was professional. Required
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

The representative was knowledgeable. Required
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

The representative communicated effectively. Required
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Vendor Support performed the service in a reasonable amount of time. Required
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

I am satisfied with my experience with the representative. Required
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

My recent experience with Vendor Support was excellent. Required
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Vendor Support is reliable. Required
Strongly
Disagree

Disagree

Neither Agree
nor Disagree

Agree

Strongly
Agree

1

2

3

4

5

Would you like to provide a compliment, concern, or recommendation about your
experience with Vendor Support?
Please select from one of the following options. Required
Select your response
Compliment
Concern
Recommendation
Will not provide additonal feedback

If you want to provide additional feedback on your experience with Vendor Support, use the
text box below.

0/400

Next

We are asking for this information so that you can provide compliments, recommendations, or concerns to VA.1 By filling out
this survey, you are authorizing VA database access to retrieve Veteran contact information to follow up with you accordingly
for purposes of service recovery, potential crisis, or to learn more about feedback you have shared regarding your
experience with VA.2 VA may utilize individual Veteran survey data from this survey or other sources to ensure the final
scores truly and accurately represent the experiences of Veterans.3 This information is collected in accordance with section
3507 of the Paperwork Reduction Act of 1995. Title 38, United States Code, allows us to ask for this information. We
estimate that you will need an average of 3 minutes to review the instructions and complete this survey. The results of this
survey will be used to inform opportunities for program improvement in the quality of VA services. Participation in this survey
is voluntary, and your decision not to respond will have no impact on VA benefits or services which you may currently be
receiving. 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 https://www.reginfo.gov/public/do/PRAMain. Information gathered will be kept private
to the extent provided by law.
[Logic: 1). Required if CCR Open Text Box is included on survey. 2). Required if Service Recovery. 3). Required unless exception.]

Privacy Policy

FSC_VENDOR SUPPORT
V7.2 DRAFT 11/16/20
Working Draft, Pre-Decisional, Deliberative document – Internal VA Use Only

OMB Number: 2900-0876
Expiration: 03/31/2023
Estimated Burden: 3 minutes

Help us serve you better.
Please take a moment to fill out this survey. The more information you
can provide, the better we can improve our services.
If you received support for a specific system, please provide that system name below
(i.e., CEP, eCAMS, Provider Portal).

0/100

How did you contact Vendor Support about your request? (Select all that apply) Required
By phone
By email
By instant message
Other
Can Vendor Support contact you about your experience? Required
Yes, Vendor Support can contact me about my experience.
No, I do not want Vendor Support to contact me about my experience.

Next

We are asking for this information so that you can provide compliments, recommendations, or concerns to VA.1 By filling out
this survey, you are authorizing VA database access to retrieve Veteran contact information to follow up with you accordingly
for purposes of service recovery, potential crisis, or to learn more about feedback you have shared regarding your
experience with VA.2 VA may utilize individual Veteran survey data from this survey or other sources to ensure the final
scores truly and accurately represent the experiences of Veterans.3 This information is collected in accordance with section
3507 of the Paperwork Reduction Act of 1995. Title 38, United States Code, allows us to ask for this information. We
estimate that you will need an average of 3 minutes to review the instructions and complete this survey. The results of this
survey will be used to inform opportunities for program improvement in the quality of VA services. Participation in this survey
is voluntary, and your decision not to respond will have no impact on VA benefits or services which you may currently be
receiving. 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 https://www.reginfo.gov/public/do/PRAMain. Information gathered will be kept private
to the extent provided by law.
[Logic: 1). Required if CCR Open Text Box is included on survey. 2). Required if Service Recovery. 3). Required unless exception.]

Privacy Policy

FSC
V7.2 DRAFT 11/16/20
Working Draft, Pre-Decisional, Deliberative document – Internal VA Use Only

OMB Number: 2900-0876
Expiration: 03/31/2023
Estimated Burden: 3 minutes

Help us serve you better.
Please take a moment to fill out this survey. The more information you
can provide, the better we can improve our services.
Provide your full name below. Required

0/100

Provide your preferred contact information below. Required
Email

0/100

Phone

0/100

Finish

We are asking for this information so that you can provide compliments, recommendations, or concerns to VA.1 By filling out
this survey, you are authorizing VA database access to retrieve Veteran contact information to follow up with you accordingly
for purposes of service recovery, potential crisis, or to learn more about feedback you have shared regarding your
experience with VA.2 VA may utilize individual Veteran survey data from this survey or other sources to ensure the final
scores truly and accurately represent the experiences of Veterans.3 This information is collected in accordance with section
3507 of the Paperwork Reduction Act of 1995. Title 38, United States Code, allows us to ask for this information. We
estimate that you will need an average of 3 minutes to review the instructions and complete this survey. The results of this
survey will be used to inform opportunities for program improvement in the quality of VA services. Participation in this survey
is voluntary, and your decision not to respond will have no impact on VA benefits or services which you may currently be
receiving. 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 https://www.reginfo.gov/public/do/PRAMain. Information gathered will be kept private
to the extent provided by law.
[Logic: 1). Required if CCR Open Text Box is included on survey. 2). Required if Service Recovery. 3). Required unless exception.]

Privacy Policy

FSC
V7.2 DRAFT 11/16/20
Working Draft, Pre-Decisional, Deliberative document – Internal VA Use Only

OMB Number: 2900-0876
Expiration: 03/31/2023
Estimated Burden: 3 minutes

Thank you.
Thank you for taking the time to share your feedback.
The U.S. Department of Veterans Affairs use these surveys to collect
your feedback in order to continuously improve your experience with
our services.

We are asking for this information so that you can provide compliments, recommendations, or concerns to VA.1 By filling out
this survey, you are authorizing VA database access to retrieve Veteran contact information to follow up with you accordingly
for purposes of service recovery, potential crisis, or to learn more about feedback you have shared regarding your
experience with VA.2 VA may utilize individual Veteran survey data from this survey or other sources to ensure the final
scores truly and accurately represent the experiences of Veterans.3 This information is collected in accordance with section
3507 of the Paperwork Reduction Act of 1995. Title 38, United States Code, allows us to ask for this information. We
estimate that you will need an average of 3 minutes to review the instructions and complete this survey. The results of this
survey will be used to inform opportunities for program improvement in the quality of VA services. Participation in this survey
is voluntary, and your decision not to respond will have no impact on VA benefits or services which you may currently be
receiving. 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 https://www.reginfo.gov/public/do/PRAMain. Information gathered will be kept private
to the extent provided by law.
[Logic: 1). Required if CCR Open Text Box is included on survey. 2). Required if Service Recovery. 3). Required unless exception.]

Privacy Policy