| SSA My Social Security v2 | |||||||||||||||||||||
| Partitioned Yes | 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 | Model and Custom Question Checks_ SRA | ||||||||||||||||||||
| 5 | Model and Custom Question Checks_ Team LeadManager | ||||||||||||||||||||
| 6 | Model and Custom Question Checks_ DOT | ||||||||||||||||||||
| 7 | Foreign Language Survey Instructions | ||||||||||||||||||||
| Model Instance Name: |
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| SSA My Social Security v2 | |||||||||||||
| MID: | Z5w0N58sJ5AkRkYUg4pVFg== | ||||||||||||
| Partitioned Yes | 2/8/2012 | ||||||||||||
| 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 | |||||||||||||
| Welcome Text | |||||||||||||
| Thank you for visiting our site. 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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| Thank you for taking our survey and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website. |
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| us | |||||||||||||
| Model Instance Name: | ||||||||||
| SSA My Social Security v2 |
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| MID: | R9JQtMNl09w1VJAZFxsVYQ4C | |||||||||
| Partitioned Yes | ||||||||||
| FPI Included(Y/N)? | ||||||||||
| Date: | 6/12/2013 | |||||||||
| SSA My Social Security v2 | ||||||||||
| Model questions utilize the ACSI methodology to determine scores and impacts | ||||||||||
| ELEMENTS (drivers of satisfaction) | CUSTOMER SATISFACTION | FUTURE BEHAVIORS | FPI | |||||||
| MQ Label | MQ Label | MQ Label | Y? | |||||||
| Look and Feel (1=Poor, 10=Excellent, Don't Know) | Satisfaction | Recommend (1=Very Unlikely, 10=Very Likely) | ||||||||
| Look and Feel - Appeal | Please rate the visual appeal of this site. | Satisfaction - Overall | What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied) |
Recommend | How likely are you to recommend this site to someone else? | |||||
| Look and Feel - Balance | Please rate the balance of graphics and text on this site. | Satisfaction - Expectations | How well does this site meet your expectations? (1=Falls Short, 10=Exceeds) |
Return (1=Very Unlikely, 10=Very Likely) | ||||||
| Look and Feel - Readability | Please rate the readability of the pages on this site. | Satisfaction - Ideal | How does this site compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close) |
Return | How likely are you to return to this site? | |||||
| Navigation (1=Poor, 10=Excellent, Don't Know) | Use Web Channel Over Others (1=Very Unlikely, 10=Very Likely) | |||||||||
| Navigation - Organized | Please rate how well the site is organized. | Use Web Channel Over Others | How likely are you to use this site rather than seek information from other channels (i.e. local field office, call center)? | |||||||
| Navigation - Options | Please rate the options available for navigating this site. | |||||||||
| Navigation - Layout | Please rate how well the site layout helps you find what you are looking for. |
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| Site Performance (1=Poor, 10=Excellent, Don't Know) | ||||||||||
| Site Performance - Loading | Please rate how quickly pages load on this site. | |||||||||
| Site Performance - Consistency | Please rate the consistency of speed from page to page on this site. | |||||||||
| Site Performance - Errors | Please rate the ability to load pages without getting error messages on this site. | |||||||||
| My Social Security Information (1=Poor, 10=Excellent, Don't Know) | ||||||||||
| My Social Security Information - Thoroughness | Please rate the thoroughness of information you viewed on this site today. | |||||||||
| My Social Security Information - Quality | Please rate the quaility of information you viewed today. | |||||||||
| My Social Security Information - Provided Answers | Please rate how well the information viewed today provided answers to your questions. | |||||||||
| Plain Language (1=Poor, 10=Excellent, Don't Know) | ||||||||||
| Plain Language - Clear | Please rate the clarity of the wording on this site. | |||||||||
| Plain Language - Understandable | Please rate how well you understand the wording on this site. | |||||||||
| Plain Language - Concise | Please rate this site on its use of short, clear sentences. | |||||||||
| Model Instance Name: | ||||||||||
| SSA My Social Security v2 | underlined & italicized: RE-ORDER | |||||||||
| MID: | R9JQtMNl09w1VJAZFxsVYQ4C | pink: ADDITION | ||||||||
| Partitioned Yes | 2/8/2012 | blue + -->: REWORDING | ||||||||
| SSA My Social Security v2 CUSTOM QUESTION LIST | ||||||||||
| QID | Skip Logic Label | Question Text | Answer Choices (limited to 50 characters) |
Skip to | Type (select from list) | Single or Multi | Required Y/N |
Special Instructions | CQ Label | |
| BJL1497 | Did you register for a username and password today? | Yes | A,Z,B,C,D,DD,E | Radio button, one-up vertical | Y | Skip Logic Group | Password Registration | |||
| No | ||||||||||
| BJL1498 | A | Please tell us how long it took you to complete your registration: | Less than 10 minutes | Radio button, one-up vertical | Single | N | Skip Logic Group | Registration SAT | ||
| 11 minutes - 15 minutes | ||||||||||
| 16 minutes - 30 minutes | ||||||||||
| 31 minutes - 1 hour | ||||||||||
| Greater than 1 hour | ||||||||||
| Z | Prior to successfully creating a username and password today, have you previously visited the site to create a username and password? | Yes | Radio button, one up vertical | Single | Y | skip logic | Previous attempts to create username Password | |||
| No | ||||||||||
| I don't recall | ||||||||||
| BJL1499 | B | Did you register for Extra Security today? | Yes | Radio button, one-up vertical | N | Skip Logic Group | ExtraSecurityReg | |||
| No | ||||||||||
| I tried but was unsuccessful | ||||||||||
| I don't know | ||||||||||
| BJL1500 | C | Did you understand all the instructions for registering for a username and password today? | Yes | Radio button, one-up vertical | Single | N | Skip Logic Group | Instructions | ||
| Partially | CC | |||||||||
| No | CC | |||||||||
| BJL1501 | CC | Please explain what you did not understand about the instructions. | Text area, no char limit | N | Skip Logic Group | OE_Instructions | ||||
| BJL1502 | D | Did you see any information describing the website's security policies or features? | Yes | Radio button, one-up vertical | Single | N | Skip Logic Group | Security | ||
| No | ||||||||||
| BJL1503 | DD | Do you have any concerns about the security of transactions on this website? | Yes | DDD | Radio button, one-up vertical | Single | N | Skip Logic Group | Security Concerns | |
| No | ||||||||||
| BJL1504 | DDD | Please describe your concerns with the security of this site. | Text area, no char limit | N | OE_Security Concerns | |||||
| BJL1505 | E | What would you like us to improve, if anything, about this site's registration process? | Text area, no char limit | N | Skip Logic Group | OE_Reg Improvement | ||||
| Including today, how often have you accessed your My Social Security account? | This is my first time | radial button one up vertical | Single | Y | Access Frequency | |||||
| 2-4 times | ||||||||||
| 5-8 times | ||||||||||
| 9 or more times | ||||||||||
| BJL1506 | Are you currently receiving cash benefits? | Yes, I am receiving Supplemental Security Income (SSI) | check box vertical | Single | Y | Skip Logic Group | Cash Benefits | |||
| Yes, I am receiving Social Security Benefits (retirement, Disability, or Survivors) | ||||||||||
| Yes, I am receiving both SSI and Social Security Benefits (Retirement, Disability, or Survivors) | ||||||||||
| Recently applied for Social Security Benefits (Retirement, Disability, or Survivors) or SSI | ||||||||||
| No (not receiving any benefit or receiving Medicare Only) | ||||||||||
| I don't know or prefer not to answer | ||||||||||
| What was your primary reason for visiting today? (Check all that apply) | To print or view my Social Security Statement | radio button, one up vertical | Multi | y | skip logic | Primary Reason | ||||
| To check my earnings record | ||||||||||
| To view my Benefits and Payment Details | ||||||||||
| To get a Benefit Verification Letter | A | |||||||||
| Add Extra Security to my online account | ||||||||||
| To update my address | ||||||||||
| To enroll or update my direct deposit | ||||||||||
| To find a form (W-2, etc..) | ||||||||||
| Just curious - wanted to see what information was available with an online account | ||||||||||
| Other reason for visiting today: | Z | |||||||||
| A | Which Agency or program requested you obtain a Benefit Verification Letter? (Check all that apply) | USDA - SNAP | radio button, one up vertical | multi | y | skip logic | Requested iBeve | |||
| IRS | ||||||||||
| HUD | ||||||||||
| U.S. Department of Veterans Affairs | ||||||||||
| Applying for a Retirement Visa in another country | ||||||||||
| Medicare | ||||||||||
| Medicaid | ||||||||||
| Z | Please tell us what your primary reason was for visiting today: | text area, no char limit | n | Skip Logic Group | OE_Primary Reason | |||||
| BJL1513 | Now that you've looked at your online statement, how often do you think you'll return to review it? | Less frequently than once a year | Dropdown (Select-one) | Single | Y | View Statement | ||||
| At least once a year | ||||||||||
| Every 6 months | ||||||||||
| Once a quarter | ||||||||||
| Once a month | ||||||||||
| More frequently than once a month | ||||||||||
| Other | ||||||||||
| BJL1514 | Were you able to accomplish what you wanted to on the site today? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic Group | Task Accomplishment | |||
| No | X,Y | |||||||||
| X | Please explain why you were unable to accomplish your task today. | text area, no char limit | N | OE_unable to Accomplish | ||||||
| BJL1515 | Y | Since you were not able to accomplish what you wanted to do today, what do you plan to do next? (Please select all that apply) | Return and try again | Checkbox | Multi | Y | Skip Logic Group | Do Next | ||
| Visit a local Social Security office | ||||||||||
| Call a local Social Security office | ||||||||||
| Call Social Security's 800 number | ||||||||||
| Submit an e-mail to Social Security | ||||||||||
| Write a letter to Social Security | ||||||||||
| Take no action | ||||||||||
| Other, please specify | YY | |||||||||
| BJL1516 | YY | Please tell us what other action you plan to take next. | Text area, no char limit | N | OE_Do Next | |||||
| BJL1517 | Was there any information on the site that was unclear to you? | No, all the information was clear | Checkbox | Multi | N | Clarity of Info | ||||
| The language used | ||||||||||
| How to print a statement | ||||||||||
| Instructions for registering for a username and password | ||||||||||
| Instructions for resetting a password and/or recalling a username | ||||||||||
| Other | ||||||||||
| BJL1518 | What did you like most about your experience today? | Text area, no char limit | N | OE_Like | ||||||
| BJL1519 | What did you like least about your experience today? | Text area, no char limit | N | OE_Dislike | ||||||
| BJL1520 | Please select the category that includes your age. | 18-24 | Drop down, select one | Single | N | Age | ||||
| 25-34 | ||||||||||
| 35-44 | ||||||||||
| 45-54 | ||||||||||
| 55-59 | ||||||||||
| 60-64 | ||||||||||
| 65-74 | ||||||||||
| 75 or older | ||||||||||
| Prefer not to answer | ||||||||||
| Model Instance Name: | ||||||||||
| SSA My Social Security | underlined & italicized: RE-ORDER | |||||||||
| MID: Z5w0N58sJ5AkRkYUg4pVFg== | pink: ADDITION | |||||||||
| Partitioned Yes | 2/8/2012 | blue + -->: REWORDING | ||||||||
| SSA My Social Security CUSTOM QUESTION LIST | ||||||||||
| QID | Skip Logic Label | Question Text | Answer Choices (limited to 50 characters) |
Skip to | Type (select from list) | Single or Multi | Required Y/N |
Special Instructions | CQ Label | |
| SAC7234 | Did you register for a username and password today? | Yes | A,B,C,D,DD,E | Y | Skip Logic Group | Password Registration | ||||
| No | ||||||||||
| SAC7235 | A | Please tell us how long it took you to complete your registration: | Less than 10 minutes | Radio button, one-up vertical | Single | N | Skip Logic Group | Registration SAT | ||
| 11 minutes - 15 minutes | ||||||||||
| 16 minutes - 30 minutes | ||||||||||
| 31 minutes - 1 hour | ||||||||||
| Greater than 1 hour | ||||||||||
| SAC7236 | B | Did you register for Extra Security today? | Yes | N | Skip Logic Group | ExtraSecurityReg | ||||
| No | ||||||||||
| I don't know | ||||||||||
| SAC7237 | C | Did you understand all the instructions for registering for a username and password today? | Yes | Single | N | Skip Logic Group | Instructions | |||
| Partially | CC | |||||||||
| No | CC | |||||||||
| SAC7238 | CC | Please explain what you did not understand about the instructions. | Text area, no char limit | N | Skip Logic Group | OE_Instructions | ||||
| SAC7239 | D | Did you see any information describing the website's security policies or features? | Yes | Radio button, one-up vertical | Single | N | Skip Logic Group | Security | ||
| No | ||||||||||
| SAC7240 | DD | Do you have any concerns about the security of transactions on this website? | Yes | DDD | Single | N | Skip Logic Group | Security Concerns | ||
| No | ||||||||||
| SAC7241 | DDD | Please describe your concerns with the security of this site. | Text area, no char limit | N | OE_Security Concerns | |||||
| SAC7242 | E | What would you like us to improve, if anything, about this site's registration process? | Text area, no char limit | N | Skip Logic Group | OE_Reg Improvement | ||||
| ACQWro0020553 | Are you currently receiving cash benefits? | Yes, I am receiving Supplemental Security Income (SSI) | A | Radio button, one-up vertical | Single | Y | Skip Logic Group | Cash Benefits | ||
| Yes, I am receiving Social Security Benefits (retirement, Disability, or Survivors) | B | |||||||||
| Yes, I am receiving both SSI and Social Security Benefits (Retirement, Disability, or Survivors) | A | |||||||||
| Recently applied for Social Security Benefits (Retirement, Disability, or Survivors) or SSI | C | |||||||||
| No (not receiving any benefit or receiving Medicare Only) | C | |||||||||
| I don't know or prefer not to answer | C | |||||||||
| ACQWro0020554 | A | What was your primary reason for visiting today? (Check all that apply) | To print my Social Security Statement | Radio button, one-up vertical | Single | Y | Skip Logic Group | SSI Only Primary Reason | ||
| To check my earnings record | ||||||||||
| To view my Benefits and Payment Details | ||||||||||
| To get a Benefit Verification Letter | ||||||||||
| Add Extra Security to my online account | ||||||||||
| Just curious - wanted to see what information was available with an online account | ||||||||||
| Other reason for visiting today: | AA | |||||||||
| ACQWro0020555 | AA | Please tell us what your primary reason was for visiting today: | Text area, no char limit | N | Skip Logic Group | OE_SSI Only Other Primary Reason | ||||
| ACQWro0020556 | B | What was your primary reason for visiting today? (Check all that apply) | To print my Social Security Statement | Radio button, one-up vertical | Single | Y | Skip Logic Group | Cash Benefit Primary Reason | ||
| To check my earnings record | ||||||||||
| To view my Benefits and Payment Details | ||||||||||
| To get a Benefit Verification Letter | ||||||||||
| Add Extra Security to my online account | ||||||||||
| Just curious - wanted to see what information was available with an online account | ||||||||||
| To update my address | ||||||||||
| To enroll or update my direct deposit | ||||||||||
| Other reason for visiting today: | BB | |||||||||
| ACQWro0020576 | BB | Please tell us what your primary reason was for visiting today: | Text area, no char limit | N | Skip Logic Group | OE_Cash Benefit primary reason | ||||
| ACQWro0020578 | C | What was your primary reason for visiting today? (Check all apply) | To print my Social Security Statement | Radio button, one-up vertical | Single | Y | Skip Logic Group | No cash Benefit | ||
| To check my earnings record | ||||||||||
| To view my estimated benefits | ||||||||||
| Add Extra Security to my online account | ||||||||||
| Just curious - wanted to see what information was available with an online account | ||||||||||
| Other reason for visiting today: | CC | |||||||||
| ACQWro0020579 | CC | Please tell us what your primary reason was for visiting today: | Text area, no char limit | N | Skip Logic Group | OE_No cash Benefit Primary Reason | ||||
| ACQhar0016936 | Now that you've looked at your online statement, how often do you think you'll return to review it? | Less frequently than once a year | Dropdown (Select-one) | Single | Y | View Statement | ||||
| At least once a year | ||||||||||
| Every 6 months | ||||||||||
| Once a quarter | ||||||||||
| Once a month | ||||||||||
| More frequently than once a month | ||||||||||
| Other | ||||||||||
| SAC7245 | Were you able to accomplish what you wanted to on the site today? | Yes | Radio button, one-up vertical | Single | Y | Skip Logic Group | Task Accomplishment | |||
| No | Y | |||||||||
| SAC7246 | Y | Since you were not able to accomplish what you wanted to do today, what do you plan to do next? (Please select all that apply) | Return and try again | Checkbox | Multi | Y | Skip Logic Group | Do Next | ||
| Visit a local Social Security office | ||||||||||
| Call a local Social Security office | ||||||||||
| Call Social Security's 800 number | ||||||||||
| Submit an e-mail to Social Security | ||||||||||
| Write a letter to Social Security | ||||||||||
| Take no action | ||||||||||
| Other, please specify | YY | |||||||||
| SAC7247 | YY | Please tell us what other action you plan to take next. | Text area, no char limit | N | OE_Do Next | |||||
| SAC7248 | Was there any information on the site that was unclear to you? | No, all the information was clear | Checkbox | Multi | N | Skip Logic Group | Clarity of Info | |||
| The language used | ||||||||||
| How to print a statement | ||||||||||
| Instructions for registering for a username and password | ||||||||||
| Instructions for resetting a password and/or recalling a username | ||||||||||
| Other | ||||||||||
| SAC7250 | What did you like most about your experience today? | Text area, no char limit | N | OE_Like | ||||||
| SAC7251 | What did you like least about your experience today? | Text area, no char limit | N | OE_Dislike | ||||||
| SAC7253 | Please select the category that includes your age. | 18-24 | Drop down, select one | Single | N | Age | ||||
| 25-34 | ||||||||||
| 35-44 | ||||||||||
| 45-54 | ||||||||||
| 55-59 | ||||||||||
| 60-64 | ||||||||||
| 65-74 | ||||||||||
| 75 or older | ||||||||||
| Prefer not to answer | ||||||||||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |