Download:
pdf |
pdfDisability Awareness Campaign Survey 1 and 2
*1. Have you used any of the materials posted to Social Security's Disability Materials for
Groups and Organizations web page?
j Yes
k
l
m
n
j No
k
l
m
n
Organization
2. Name of your organization, company, or agency
Communication
3. How did you find out about the online disability materials?
j I saw it on Facebook, Twitter, or other social networking site
k
l
m
n
j I heard about it from a coworker
k
l
m
n
j I saw it on the Social Security website
k
l
m
n
j I heard about it from a Social Security employee
k
l
m
n
j I heard about it from my local advocate group (for example, newsletter or website)
k
l
m
n
Other (please specify)
Customer Satisfaction
4. Which of these types of media do you find most helpful? Select all that apply.
c Fact Sheet
d
e
f
g
c Social Media
d
e
f
g
c Posters
d
e
f
g
c Newsletter Articles
d
e
f
g
c PowerPoint Presentations
d
e
f
g
c Videos
d
e
f
g
c Web Widget
d
e
f
g
Page 1
Disability Awareness Campaign Survey 1 and 2
5. Which of these types of media do you find least helpful? Select all that apply.
c Fact Sheet
d
e
f
g
c Social Media
d
e
f
g
c Posters
d
e
f
g
c Newsletter Articles
d
e
f
g
c PowerPoint Presentations
d
e
f
g
c Videos
d
e
f
g
c Web Widget
d
e
f
g
6. How would you rate the overall quality of the materials provided?
j Excellent
k
l
m
n
j Above average
k
l
m
n
j Average
k
l
m
n
j Below average
k
l
m
n
j Poor
k
l
m
n
Other Materials
7. What other materials would you like to see on the "Disability Materials for Groups and
Organizations" web page?
5
6
Fact Sheet Usage
*8. Did you use the fact sheet, Facts About Social Security's Disability Program?
j Yes
k
l
m
n
j No
k
l
m
n
Fact Sheets
Page 2
Disability Awareness Campaign Survey 1 and 2
9. When you used the fact sheet, Facts About Social Security's Disability Program, how
did you use it?
c Printouts
d
e
f
g
c A link to the fact sheet from my organization's website
d
e
f
g
c We did not use the fact sheet
d
e
f
g
Other (please specify)
Social Media Facebook 1
*10. Did your organization put any of the social media posts on Facebook?
j Yes
k
l
m
n
j No
k
l
m
n
Social Media Facebook 2
11. How many friends follow your organization's Facebook page?
12. If your organization posted any of the following social media posts to Facebook,
please indicate the date of the post.
MM
DD
YYYY
The Social Security Act sets out a very strict definition of disability
/
/
Severe disabilities often mean a shorter time collecting benefits
/
/
The onset of disability is unpredictable and can happen to anyone at any age
/
/
Social Security disability is insurance coverage that workers earn
/
/
As experts projected for decades, Social Security claims have increased
/
/
/
/
significantly
Social Security Disability payments are modest
Social Media Twitter 1
*13. Did your organization use any of the social media articles on Twitter?
j Yes
k
l
m
n
j No
k
l
m
n
Social Media Twitter 2
Page 3
Disability Awareness Campaign Survey 1 and 2
14. How many followers does your organization's Twitter account have?
15. If your organization posted any of the following social media posts on Twitter, please
indicate the date of the post.
MM
DD
YYYY
The Social Security Act sets out a very strict definition of disability
/
/
Severe disabilities often mean a shorter time collecting benefits
/
/
The onset of disability is unpredictable and can happen to anyone at any age
/
/
Social Security disability is insurance coverage that workers earn
/
/
As experts projected for decades, Social Security claims have increased
/
/
/
/
significantly
Social Security Disability payments are modest
Social Media Other 1
*16. Other than Facebook and Twitter, does your organization use any other type of
social media account?
j Yes
k
l
m
n
j No
k
l
m
n
Social Media Other 2
17. What other type of social media does your organization use?
18. How many people does your organization reach with your other social media account?
19. If your organization posted any of the following social media posts to your other social
media account, please indicate the date of the post.
MM
DD
YYYY
The Social Security Act sets out a very strict definition of disability
/
/
Severe disabilities often mean a shorter time collecting benefits
/
/
The onset of disability is unpredictable and can happen to anyone at any age
/
/
Social Security disability is insurance coverage that workers earn
/
/
As experts projected for decades, Social Security claims have increased
/
/
/
/
significantly
Social Security Disability payments are modest
Page 4
Disability Awareness Campaign Survey 1 and 2
Posters
*20. Did your organization use any of the posters on Social Security's Disability Materials
for Groups and Organizations web page?
j Yes
k
l
m
n
j No
k
l
m
n
Posters 2
21. Which of the following posters did you print and distribute? Select all that apply.
c Amputee & PostTraumatic Stress Disorder
d
e
f
g
c Spinal Cord Injury
d
e
f
g
c Clinical Depression
d
e
f
g
c Vision Impairment
d
e
f
g
c Brittle Bone Disease
d
e
f
g
c Down Syndrome
d
e
f
g
c Cerebral Palsy
d
e
f
g
c Breast Cancer
d
e
f
g
c Multiple Sclerosis
d
e
f
g
c Schizophrenia
d
e
f
g
c Congenital Disorder
d
e
f
g
c Hearing Impairment
d
e
f
g
c Social Security works aggressively to prevent, detect and prosecute fraud (SSN Card)
d
e
f
g
c Social Security works aggressively to prevent, detect and prosecute fraud (Man & Computer)
d
e
f
g
c Facts About Social Security’s Disability Program (colorful)
d
e
f
g
c Facts About Social Security’s Disability Program (list version)
d
e
f
g
c Did you know: Social Security disability insurance makes it possible…
d
e
f
g
c Did you know: People who receive Social Security disability payments…
d
e
f
g
22. In total, about how many posters did you distribute?
Number
Newsletter Articles
Page 5
Disability Awareness Campaign Survey 1 and 2
*23. Did your organization use any of the newsletter articles on Social Security's
Disability Materials for Groups and Organizations web page?
j Yes
k
l
m
n
j No
k
l
m
n
Newsletter 1
24. Does your organization produce an online or printed newsletter?
j Yes
k
l
m
n
j No
k
l
m
n
Newsletter 2
25. What is the name of your Organization's newsletter?
26. How many subscribers does your newsletter have?
Article Usage
27. Please indicate the date the newsletter article was posted.
MM
DD
YYYY
1
/
/
2
/
/
3
/
/
PowerPoint Slides
*28. Has your organization used the PowerPoint, "Social Security's Disability Programs"
in any presentations?
j Yes
k
l
m
n
j No
k
l
m
n
PowerPoint Presentation
Page 6
Disability Awareness Campaign Survey 1 and 2
29. What was/were the date(s) of your presentation(s)?
MM
DD
YYYY
Date 1
/
/
Date 2
/
/
Date 3
/
/
Date 4
/
/
Date 5
/
/
30. What was the audience size for each of your presentations?
Date 1
Date 2
Date 3
Date 4
Date 5
Videos
31. From the list of videos below, indicate those which you shared on You Tube by
showing the date of the post.
MM
DD
YYYY
Personal Interview Video – Sarah
/
/
Personal Interview Video – Richard
/
/
Personal Interview Video – Erika
/
/
Personal Interview Video – Karen
/
/
Personal Interview Video – Carrie
/
/
Personal Interview Video – William
/
/
American Sign Language Video – Social Security, SSI and Medicare
/
/
Web Widget
32. From the list of widgets below, indicate which you used on your organization's website
by showing the date of the post.
MM
DD
YYYY
FACES AND FACTS OF DISABILITY – Round
/
/
FACES AND FACTS OF DISABILITY– Square
/
/
Page 7
OMB Control No. 0960-0788
Paperwork Reduction Act Statement
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. §3507, as
amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless
we display a valid Office of Management and Budget control number. We estimate that it will take about 5 minutes
to complete this survey. You may send comments on our time estimate above: SSA, 6401 Security Blvd.,
Baltimore, MD 21235-6401. Send only comments relating to our time estimate to this address.
| File Type | application/pdf |
| File Modified | 2014-01-28 |
| File Created | 2014-01-24 |