Form 457 CQs for OMB st 457 CQs for OMB st 457 CQs for OMB started 5-17-2011

Measures Name/Client name (CQs and Answer choices)
Social Security Admin: SSA FAQ Sat Survey, MID RhtAg4UV8ddoAhlZwpFIEw==
SAC2270		Are you currently receiving Social Security Benefits?	SAC2270A001	Yes		Dropdown (Select-one)	Single	Y		Receiving SS Benefits
			SAC2270A002	No
			SAC2270A003	Not Sure
SAC2271		Which of the following topics were you were looking for within the FAQs? (check all that apply)	SAC2271A001	Social Security Benefit Statement (Form SSA-1099)		Checkbox One Up Vertical	Multi	Y	Skip Logic	Topic
			SAC2271A002	Annual Social Security Statement
			SAC2271A003	Social Security Card or Number	A
			SAC2271A004	Retirement Benefits	B
			SAC2271A005	Social Security Disability Benefits	C
			SAC2271A006	Supplemental Security Income (SSI) Payments	D
			SAC2271A007	Survivor Benefits	E
			SAC2271A008	Medicare Benefits	F
			SAC2271A009	Address change
			SAC2271A010	Direct deposit of monthly check
			SAC2271A011	Paying taxes on Social Security benefits
			SAC2271A012	Other, please specify	Z
SAC2272	A	What Social Security card or number information were you seeking today?	SAC2272A001	Replacing a lost or stolen Social Security card		Radio Button One Up Vertical	Single	Y	Skip Logic	SSCard/#
			SAC2272A002	Changing a name on a Social Security card
			SAC2272A003	Requesting a Social Security card for a minor child
			SAC2272A004	Learning what documents are needed
			SAC2272A005	Other, please specify	AA
SAC2273	AA	Please tell us what other Social Security card or number information you wanted.				Text Area – no character limit		N	Skip Logic	OE_SSCard/#
SAC2274	B	What best describes the subject of your Retirement Benefits question?	SAC2274A001	Applying for Retirement benefits – how and when		Radio Button One Up Vertical	Single	Y	Skip Logic	Retirement
			SAC2274A002	Estimating Retirement benefits
			SAC2274A003	Working while receiving Retirement benefits
			SAC2274A004	Learning what documents are needed to file for Retirement benefits
			SAC2274A005	Learning about benefits for a spouse and/or child(ren)
			SAC2274A006	Other, please specify	BB
SAC2275	BB	Please tell us about your Retirement Benefits question.				Text Area – no character limit		N	Skip Logic	OE_Retirement
SAC2276	C	What best describes the subject of your Social Security Disability benefits question?	SAC2276A001	Applying for Disability benefits – how and when		Radio Button One Up Vertical	Single	Y	Skip Logic	Disability
			SAC2276A002	Learning about benefits for spouse and/or child(ren)
			SAC2276A003	Appealing an adverse Disability decision – how and when
			SAC2276A004	Working while disabled
			SAC2276A005	Other, please specify	CC
SAC2277	CC	Please tell us about your Social Security Disability question.				Text Area – no character limit		N	Skip Logic	OE_Disability
SAC2278	D	What Supplemental Security Income (SSI) information were you seeking?	SAC2278A001	Applying for SSI payments – how and when		Radio Button One Up Vertical	Single	Y	Skip Logic	SSI
			SAC2278A002	Learning the difference between SSI and Social Security benefit payments
			SAC2278A003	Learning what affects SSI payments (e.g., work, property, savings, inheritance, etc.)
			SAC2278A004	Learning if a spouse and/or child(ren) can receive payments from my SSI record
			SAC2278A005	Other, please specify	DD
SAC2279	DD	Please tell us about your Supplemental Security Income (SSI) question.				Text Area – no character limit		N	Skip Logic	OE_SSI
SAC2280	E	What Survivor Benefits information were you seeking?	SAC2280A001	Applying for Survivor Benefits - how and when		Radio Button One Up Vertical	Single	Y	Skip Logic	Survivor Benefits
			SAC2280A002	Receiving Survivor Benefits AND my own retirement benefit
			SAC2280A003	Receiving Survivor Benefits on a divorced spouse’s record
			SAC2280A004	Obtaining necessary documents needed to file for survivor benefits
			SAC2280A005	Learning how remarriage affects my survivor benefits
			SAC2280A006	Other, please specify	EE
SAC2281	EE	Please tell us about your Survivor Benefits question.				Text Area – no character limit		N	Skip Logic	OE_Survivor
SAC2282	F	What best describes the subject of your Medicare question?	SAC2282A001	How to apply for Medicare benefits – how and when?		Radio Button One Up Vertical	Single	Y	Skip Logic	Medicare
			SAC2282A002	What documents are needed to file for Medicare
			SAC2282A003	Who is eligible for Medicare
			SAC2282A004	What is covered under the Medicare program
			SAC2282A005	What are the Medicare premiums
			SAC2282A006	What is the Medicare Prescription Drug Plan
			SAC2282A007	Other, please specify	FF
SAC2283	FF	Please tell us about your Medicare question.				Text Area – no character limit		N	Skip Logic	OE_Medicare
SAC2284	Z	Please tell us what other information you were seeking.				Text Area – no character limit		N	Skip Logic	OE_Topic
4969		Did we answer your question(s)?		Yes, my question (s) was answered completely	A	Dropdown (Select-one)	Single	Y	Skip Logic	Answer Questions
				Yes, my question (s) was answered partially	A, B
				No, my question (s) was not answered at all	B
SAC2285	A	Did the answer(s) you received using our FAQs help you accomplish your task with Social Security?	SAC2285A001	Yes		Dropdown (Select-one)	Single	Y	Skip Logic	Help Accomplish
			SAC2285A002	No
			SAC2285A003	Partially
7786	B	If we didn't answer your question(s), please tell us what information you were looking for? --> What was your question? Please explain:				Text Area – no character limit		N	Skip Logic	Information Sought --> OE_No Answer
SAC2286		Please tell us if you had any of the following concerns or problems while using the FAQs? (check all that apply)	SAC2286A001	Experienced no problems		Checkbox One Up Vertical	Multi	N	Skip Logic	Problems
			SAC2286A002	Could not figure out the best way to find the answers I needed
			SAC2286A003	Too many answers to choose from
			SAC2286A004	Answer link(s) did not take me where I expected
			SAC2286A005	Found the answer link(s) difficult to understand
			SAC2286A006	Answers were too long
			SAC2286A007	Had difficulty understanding the information in the answer
			SAC2286A008	Experienced technical difficulties (e.g. broken links, error messages)
			SAC2286A009	Took me too long to search through the FAQs
			SAC2286A010	Other, please specify	A
SAC2287	A	Please tell us about your concerns or problems using the FAQs.				Text Area – no character limit		N	Skip Logic	OE_Problems
SAC2288		Which FAQ feature(s) did you use today? (check all that apply)	SAC2288A001	Most Popular Answer links		Checkbox One Up Vertical	Multi	Y	Skip Logic	FAQ Feature
			SAC2288A002	Most Popular Topic links
			SAC2288A003	Browse All Topic links
			SAC2288A004	FAQ Search Box	A
			SAC2288A005	Not sure
			SAC2288A006	None of the above
SAC2289	A	Which of the following, if any, did you experience while using the FAQ Search tool today? (check all that apply)	SAC2289A001	Experienced no problems		Checkbox One Up Vertical	Multi	Y	Skip Logic	Search
			SAC2289A002	Results were not relevant to my search terms or needs
			SAC2289A003	I was not sure what words to use in my search
			SAC2289A004	Search required too many refinements to get to what I wanted
			SAC2289A005	Returned too many results
			SAC2289A006	Returned not enough results
			SAC2289A007	Returned no results
			SAC2289A008	Returned results were too similar or redundant
			SAC2289A009	Other, please specify	B
SAC2290	B	Please tell us about your FAQ search experience.				Text Area – no character limit		N	Skip Logic	OE_Search
SAC2291		What will your next step(s) be relative to the information you were seeking? (choose the one that most applies)	SAC2291A001	I got the information I was seeking and have no plans to follow up with SSA		Radio Button One Up Vertical	Single	Y		Next Steps
			SAC2291A002	I will conduct my SSA business online (if available)
			SAC2291A003	I will visit my local SSA office
			SAC2291A004	I will call my local SSA office
			SAC2291A005	I will call the SSA Toll Free 800 Number
			SAC2291A006	I will email SSA
			SAC2291A007	I did not get the information I was seeking but have no plans to follow up with SSA
			SAC2291A008	Not sure what my next steps will be
SAC2292		How frequently do you visit SSA’s FAQ section?	SAC2292A001	First time		Radio Button One Up Vertical	Single	Y		Visit Frequency
			SAC2292A002	At least once a week
			SAC2292A003	At least once a month
			SAC2292A004	At least once every six months
			SAC2292A005	At least once a year
			SAC2292A006	Not sure
811		What is your age group?		Under 18		Dropdown (Select-one)	Single	Y		Age
				18-24				N
				25-44
				45-54
				55-64
				65+
SAC2293		Do you have any suggestions for improving the FAQ section?				Text Area – no character limit		N		Improve
USDA Forest Service Content + Search
C5316		In what capacity are you visiting the Forest Service website?		Government (federal, state, local or Forest Service)		Radio button, one-up vertical	Single	Y	OPS Group
				Private sector (business owner/employee)
				Professor or student
				U.S. Citizen/public
				Non U.S. citizen
				Primary or Secondary Education Student
				University Student
				Primary or Secondary Education Teacher
				University Professor
				General public
				Other (Please specify)	A
	A	Other:				Text field, <100 char		N	OPS Group
C5309		What is your primary purpose in visiting this site today?		Contact information (phone numbers)		Radio button, one-up vertical	Single	Y	Skip Logic Group
				Current forest conditions (e.g. fire activity, road closures, weather)
				Employment or volunteering opportunities
				Employment
				Volunteering Opportunities
				Natural resource management (policy, plans, programs and projects)
				Official communications (e.g. news releases or testimony)
				Personal-use Permit information
				Commercial-use Permit information
				Scientific information	D
				General information
				Travel or vacation planning
				To plan a visit to a national forest or grassland	B, C
				Other (Please Specify)	A
	A	Other purpose:				Text field, <100 char		N	Skip Logic Group
	B	What activity will you primarily perform during your visit to a national forest or grassland?		Alpine Skiing		Radio button, one-up vertical	Single	Y	Skip Logic Group	Activity
				Bicycling
				Boating
				Camping
				Cabin Rentals
				Canoeing
				Climbing
				Fishing
				Hiking
				Horse Riding
				Hunting
				Kayaking
				Mountain biking
				Nature Viewing
				Nordic Skiing
				OHV Riding
				Outdoor Learning
				Picknicking
				Rafting
				Rock hounding
				Scenic Driving
				Snowmobiling
				Other (Please specify)	E
	E	Other activity:				Text field, <100 char		N	Skip Logic Group	OE_Activity
	C	What visitor information are you mostly looking for? Information about:		Current forest conditions (e.g. fire activity, road closures, weather)		Radio button, one-up vertical	Single	Y	Skip Logic Group	Visitor Info
				Online maps
				Off Highway Vehicle (OHV) use
				Roads and access
				Other (Please specify)	F
	F	Other visitor information:				Text field, <100 char		N	Skip Logic Group	OE_Visitor Info
	D	What scientific information are you mostly looking for? Information about:		GIS tools		Radio button, one-up vertical	Single	Y	Skip Logic Group	Scientific Info
				Ecology management tools
				Computer-based tools
				Databases
				Fire
				Find an expert
				Journal articles
				Maps
				Photos or graphics
				Publications
				Technical manuals
				Other (Please specify)	G
	G	Other scientific information:				Text field, <100 char		N	Skip Logic Group	OE_Scientific Info
C5314		If you're seeking an online map, what best describes the kind of online maps you prefer?		Detailed and printable travel map of a National Forest or Grassland		Radio button, one-up vertical	Single	Y	OPS Group
				Simple online map that give basic location information for recreation
				Full-featured online map that would allow you to zoom, pan, etc.
				I'm not looking for an online map
				Other (Please specify)	A
	A	Other:				Text field, <100 char		N	OPS Group
CDEZ10013		What was your primary method of looking for information on our site today?		Browsed, that is, followed links in the page		Drop down, select one	Single	Y	Skip Logic Group
				Typed text in search box in upper left corner	A
				Used advanced search feature on site	A
				Used a third-party search engine (e.g., Google)
				Searched by State via the drop-down box
				Searched by Forest Name via the drop-down box
				Don't know
	A	Please tell us about your experience with the site's search feature today. (Please select all that apply.)		Search results were helpful		Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Search
				Results were not relevant/not what I wanted
				Too many results/I needed to refine my search
				Not enough results
				Returned NO results
				Received error message(s)
				Search speed was too slow
				I experienced a different search issue (please explain):	B
	B	Other search issue:				Text area, no char limit		N	Skip Logic Group	OE_Search
		Did you find what you were looking for on the site today?		Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group	Find
				Partially
				No, I wanted to find:	A
				I was just browsing
	A	Please tell us specifically what you were looking for on the site.				Text area, no char limit		N	Skip Logic Group	OE_Find
C3182		How frequently do you visit the Forest Service website?		First time		Drop down, select one	Single	Y
				More than once a day
				Daily
				About once a week
				About once a month
				Every 6 months or less
C3183		How frequently do you go to a National Forest or Grassland?		Several times a week		Drop down, select one	Single	Y
				Once a week
				Once a month
				Once every six months
				About once a year or less often
				Never
		What is your gender?		Female		Drop down, select one	Single	N		Gender
				Male
				Prefer not to respond
		What is your age range?		Under 12		Drop down, select one	Single	N		Age
				13 - 17
				18 - 25
				26 - 45
				46 - 64
				65 or older
				Prefer not to respond
C6649		Are there any additional comments you would like to provide us?				Text area, no char limit		N