| Questionnaire Management Guidelines | ||||||||||||||||||||
| Goals: | ||||||||||||||||||||
| One consolidated document to track all model and CQ changes throughout the life of the project | ||||||||||||||||||||
| Questionnaire always matches the live survey | ||||||||||||||||||||
| Easy and error-free way to submit CQ changes | ||||||||||||||||||||
| All changes tracked and reflected in one document (DOT will help) | ||||||||||||||||||||
| Questionnaire Resources: | ||||||||||||||||||||
| 1 | Questionnaire Design and Approval Process | |||||||||||||||||||
| 2 | Question Grouping Rules | |||||||||||||||||||
| 3 | OPS vs. Skip Logic Decision for "Other, Please Specify" | |||||||||||||||||||
| 4 | Foreign Language Survey Instructions | |||||||||||||||||||
| Model Instance Name: |
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| SSA Mobile Wage Reporting | |||||||||||
| MID: | oYYdlt48ctdtx8cgFh0Q4Q== |
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| Date: | 8/2/2012 | ||||||||||
| Welcome and Thank You Text | |||||||||||
| Directions: | |||||||||||
| This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome text shown in the box below. | |||||||||||
| Examples | |||||||||||
| Welcome Text Example | |||||||||||
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| Welcome Text | |||||||||||
| Thank you for using the SSI Mobile Wage Reporting app. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible. |
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| Thank You Text Example | |||||||||||
| Thank You Text |
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Please note you will not receive a response from us based on your survey comments. If you would like to get in touch with Social Security, please visit our Contact Us page to find out how. |
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| Model Instance Name: | |||||||||
| SSA Mobile Wage Reporting |
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| MID: | oYYdlt48ctdtx8cgFh0Q4Q== |
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| Partitioned (Y/N)? N | Element rotation scheme has been added | ||||||||
| NOTE: All non-partitioned surveys will NOT be imputed and the elements will be rotated as a default unless otherwise specified and approved by Research. | |||||||||
| Date: | 5/30/2012 | ||||||||
| SSA Mobile Wage Reporting | |||||||||
| Model questions utilize the ACSI methodology to determine scores and impacts | |||||||||
| ELEMENTS (drivers of satisfaction) | CUSTOMER SATISFACTION | FUTURE BEHAVIORS | |||||||
| MQ Label | MQ Label | MQ Label | |||||||
| Look and Feel (1=Poor, 10=Excellent, Don't Know) | Satisfaction | Use Again (1=Very Unlikely, 10=Very Likely) | |||||||
| Look and Feel - Appeal | Please rate the visual appeal of this mobile app. | Satisfaction - Overall | What is your overall satisfaction with this mobile app? (1=Very Dissatisfied, 10=Very Satisfied) |
Use Mobile App Again | How likely are you to use this mobile app again? | ||||
| Look and Feel - Readability | Please rate the readability of the views in this mobile app. | Satisfaction - Expectations | How well does this mobile app meet your expectations? 1=Falls Short, 10=Exceeds) |
Mobile App Channel Preference | Use over other channels (1=Very Unlikely, 10=Very Likely) | ||||
| Navigation (1=Poor, 10=Excellent, Don't Know) | Satisfaction - Ideal | How does this app compare to your idea of an ideal mobile app? (1=Not Very Close, 10=Very Close) |
How likely are you to use a mobile app to conduct business with SSA instead of using other channels such as the telephone, or going in person? | ||||||
| Navigation - Organized | Please rate how well this mobile app is organized. | ||||||||
| Navigation - Options | Please rate the options available for navigating this mobile app. | ||||||||
| App Performance (1=Poor, 10=Excellent, Don't Know) | |||||||||
| App Performance - Loading | Please rate how quickly views load in this mobile app. | ||||||||
| App Performance - Errors | Please rate the ability to load views without getting error messages in this mobile app. | ||||||||
| #REF! | ||||||||||
| SSA Mobile Wage Reporting | underlined & italicized: RE-ORDER | |||||||||
| MID: oYYdlt48ctdtx8cgFh0Q4Q== |
pink: ADDITION | |||||||||
| Date: | 1/25/2018 | blue + -->: REWORDING | ||||||||
| SSA Mobile Wage Reporting CUSTOM QUESTION LIST | ||||||||||
| QID | Skip Logic Label | Question Text | AnswerIDs (DOT) | Answer Choices (limited to 50 characters) |
Skip to | Type (select from list) | Single or Multi | Required Y/N |
Special Instructions | CQ Label |
| TAR0209325 | Who are you reporting wages for? | Myself | Radio button, one-up vertical | Single | Y | Skip logic | Reporting for | |||
| My Spouse | ||||||||||
| Myself and Spouse | ||||||||||
| Myself and Other | Q1 | |||||||||
| Other | Q1 | |||||||||
| TAR0209344 | Q1 | What is your relationship to the individual you are reporting wages for? | Text field <100 characters | N | Text area, no Char limit | OE_Relationship | ||||
| TAR0209326 | Are you reporting for more than one employer for the same person? | Yes | Radio button, one-up vertical | Single | Y | Reporting multiple employers | ||||
| No | ||||||||||
| Don't know | ||||||||||
| LNH0233 | What best describes your role? | I receive my own benefits | Radio button, one-up vertical | Single | Y | Role | ||||
| I am the representative payee for my spouse or child | ||||||||||
| I am the representative payee for someone else | ||||||||||
| Other | ||||||||||
| HAR0034853 | Is this your first time using this app? | Yes | A | Radio button, one-up vertical | Single | Y | Skip logic | Use app | ||
| No | ||||||||||
| HAR0034922 | A | Are you planning on using this app to report your wages again? | Yes | Radio button, one-up vertical | Single | Y | Skip logic | Use again | ||
| No | AA | |||||||||
| HAR0034923 | AA | Please explain why you are not planning to use this app to report your wages again. | Text area, no char limit | N | skip logic | OE_Why Not Again | ||||
| MAD0051531 | How did you learn about this app? | I first heard about it when I visited the app store | Radio button, one-up vertical | Single | Y | Find Out About App | ||||
| An SSA employee told me about it | ||||||||||
| Another agency referred me to it | ||||||||||
| I saw information about it on SSA TV | ||||||||||
| Social media (e.g., Facebook, Twitter, blog, etc.) | ||||||||||
| Other | ||||||||||
| HAR0034927 | How helpful was the instruction package you received? | Very helpful | Radio button, one-up vertical | Single | Y | Instructions Packet | ||||
| Helpful | ||||||||||
| Not helpful | ||||||||||
| I did not receive an instruction package. | ||||||||||
| MAD0051510 | Would you use this app if it were available between 11 pm and 5 am Eastern Standard Time? | Yes | Radio button, one-up vertical | Single | Y | Use app between 11pm-5am | ||||
| No | ||||||||||
| Not sure | ||||||||||
| CAS0064362 | Have you registered for a my Social Security account? | Yes | Radio button, one-up vertical | Single | Y | Registered for mySSA | ||||
| No | ||||||||||
| CAS0059588 | Have you ever used your mobile device to access other online Social Security applications or services? | Yes | A | Radio button, one-up vertical | Single | Y | Skip logic | Use Other Apps with Mobile | ||
| No | ||||||||||
| TAR0209345 | A | Which online Social Security application(s) or service(s) did you use? (Select all that apply.) | Get a Benefit Verification Letter | Checkbox, one-up vertical | Multi | N | Skip logic | Other app used | ||
| View my Benefits and Payment Details | ||||||||||
| Enroll in or update my direct deposit | ||||||||||
| Change my address with SSA | ||||||||||
| Print or view my online Social Security Statement | ||||||||||
| Make sure my earnings record is correct | ||||||||||
| Replace my Social Security Card or get a new card | ||||||||||
| Check the Status of my recently filed application for benefits | ||||||||||
| Learn about the benefits to which I might be entitled | ||||||||||
| Apply only for Social Security or Medicare Only benefits | ||||||||||
| Report my wages | ||||||||||
| Request a replacement SSA-1099 (or SSA-10425) for tax purposes | ||||||||||
| Add Extra Security to my online account | ||||||||||
| None of these | Mutually exclusive | |||||||||
| TAR0250192 | Before using the SSA app did you first try to accomplish your task in any of the following ways? | Calling Social Security's 1-800 number | Checkbox, one up vertical | Multi | Y | Skip Logic | First try | |||
| Visiting my local Social Security office | ||||||||||
| Calling my local Social Security office | ||||||||||
| No, I visited SSA.gov first | ||||||||||
| Not sure | ||||||||||
| TAR0250193 | Did you accomplish what you wanted to with the SSA app? | Yes | Radio button, one up veritical | Single | Y | Skip logic | Accomplish | |||
| Partially | A | |||||||||
| No | A | |||||||||
| TAR0250194 | A | What do you plan to do next? | Try again to complete my task online | Radio button, one up veritical | Single | Y | Skip Logic | Do next | ||
| Call Social Security's 1-800 number | ||||||||||
| Visit my local Social Security office | ||||||||||
| Call my local Social Security office | ||||||||||
| Other (please specify) | B | |||||||||
| TAR0250195 | B | What do you plan to do next? | Text area, no char limit | N | Skip Logic | OPS_Other plan next | ||||
| LNH0239 | Please provide any suggestions you may have to improve this mobile site. | Text area, no char limit | Single | N | OE_Improvement | |||||
| #REF! | ||||||||||
| SSA Mobile Wage Reporting | underlined & italicized: RE-ORDER | |||||||||
| MID: oYYdlt48ctdtx8cgFh0Q4Q== |
pink: ADDITION | |||||||||
| Date: | 1/25/2018 | blue + -->: REWORDING | ||||||||
| SSA Mobile Wage Reporting CUSTOM QUESTION LIST | ||||||||||
| QID | Skip Logic Label | Question Text | AnswerIDs (DOT) | Answer Choices (limited to 50 characters) |
Skip to | Type (select from list) | Single or Multi | Required Y/N |
Special Instructions | CQ Label |
| TAR0209325 | Who are you reporting wages for? | Myself | Radio button, one-up vertical | Single | Y | Skip logic | Reporting for | |||
| My Spouse | ||||||||||
| Myself and Spouse | ||||||||||
| Myself and Other | Q1 | |||||||||
| Other | Q1 | |||||||||
| TAR0209344 | Q1 | What is your relationship to the individual you are reporting wages for? | Text field <100 characters | N | Text area, no Char limit | OE_Relationship | ||||
| TAR0209326 | Are you reporting for more than one employer for the same person? | Yes | Radio button, one-up vertical | Single | Y | Reporting multiple employers | ||||
| No | ||||||||||
| Don't know | ||||||||||
| LNH0233 | What best describes your role? | I receive my own benefits | Radio button, one-up vertical | Single | Y | Role | ||||
| I am the representative payee for my spouse or child | ||||||||||
| I am the representative payee for someone else | ||||||||||
| Other | ||||||||||
| HAR0034853 | Is this your first time using this app? | Yes | A | Radio button, one-up vertical | Single | Y | Skip logic | Use app | ||
| No | ||||||||||
| HAR0034922 | A | Are you planning on using this app to report your wages again? | Yes | Radio button, one-up vertical | Single | Y | Skip logic | Use again | ||
| No | AA | |||||||||
| HAR0034923 | AA | Please explain why you are not planning to use this app to report your wages again. | Text area, no char limit | N | skip logic | OE_Why Not Again | ||||
| MAD0051531 | How did you learn about this app? | I first heard about it when I visited the app store | Radio button, one-up vertical | Single | Y | Find Out About App | ||||
| An SSA employee told me about it | ||||||||||
| Another agency referred me to it | ||||||||||
| I saw information about it on SSA TV | ||||||||||
| Social media (e.g., Facebook, Twitter, blog, etc.) | ||||||||||
| Other | ||||||||||
| HAR0034927 | How helpful was the instruction package you received? | Very helpful | Radio button, one-up vertical | Single | Y | Instructions Packet | ||||
| Helpful | ||||||||||
| Not helpful | ||||||||||
| I did not receive an instruction package. | ||||||||||
| MAD0051510 | Would you use this app if it were available between 11 pm and 5 am Eastern Standard Time? | Yes | Radio button, one-up vertical | Single | Y | Use app between 11pm-5am | ||||
| No | ||||||||||
| Not sure | ||||||||||
| CAS0064362 | Have you registered for a my Social Security account? | Yes | Radio button, one-up vertical | Single | Y | Registered for mySSA | ||||
| No | ||||||||||
| CAS0059588 | Have you ever used your mobile device to access other online Social Security applications or services? | Yes | A | Radio button, one-up vertical | Single | Y | Skip logic | Use Other Apps with Mobile | ||
| No | ||||||||||
| TAR0209345 | A | Which online Social Security application(s) or service(s) did you use? (Select all that apply.) | Get a Benefit Verification Letter | Checkbox, one-up vertical | Multi | N | Skip logic | Other app used | ||
| View my Benefits and Payment Details | ||||||||||
| Enroll in or update my direct deposit | ||||||||||
| Change my address with SSA | ||||||||||
| Print or view my online Social Security Statement | ||||||||||
| Make sure my earnings record is correct | ||||||||||
| Replace my Social Security Card or get a new card | ||||||||||
| Check the Status of my recently filed application for benefits | ||||||||||
| Learn about the benefits to which I might be entitled | ||||||||||
| Apply only for Social Security or Medicare Only benefits | ||||||||||
| Report my wages | ||||||||||
| Request a replacement SSA-1099 (or SSA-10425) for tax purposes | ||||||||||
| Add Extra Security to my online account | ||||||||||
| None of these | Mutually exclusive | |||||||||
| Before using the SSA app did you first try to accomplish your task in any of the following ways? | Calling Social Security's 1-800 number | Checkbox, one up vertical | Multi | Y | Skip Logic | First try | ||||
| Visiting my local Social Security office | ||||||||||
| Calling my local Social Security office | ||||||||||
| No, I visited SSA.gov first | ||||||||||
| Not sure | ||||||||||
| Did you accomplish what you wanted to with the SSA app? | Yes | Radio button, one up veritical | Single | Y | Skip logic | Accomplish | ||||
| Partially | A | |||||||||
| No | A | |||||||||
| A | What do you plan to do next? | Try again to complete my task online | Radio button, one up veritical | Single | Y | Skip Logic | Do next | |||
| Call Social Security's 1-800 number | ||||||||||
| Visit my local Social Security office | ||||||||||
| Call my local Social Security office | ||||||||||
| Other (please specify) | B | |||||||||
| B | What do you plan to do next? | Text area, no char limit | N | Skip Logic | OPS_Other plan next | |||||
| LNH0239 | Please provide any suggestions you may have to improve this mobile site. | Text area, no char limit | Single | N | OE_Improvement | |||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |