User Satisfaction Survey

National Center on Law and Elder Rights-Resource Support and User Satisfaction

0060 User Satisfaction Form

National Center on Law and Elder Rights-Resource Support Requests and User Satisfaction

OMB: 0985-0060

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The NCLER asks legal and aging network professionals that receive Legal Training, Case Consultation, and
Technical Assistance a series of survey questions presented in the web-based URSRT in order to properly assess
audience targeting, participant satisfaction and outcomes of training and technical assistance delivery as
required by the NCLER contract.
Survey Questions & General Information
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First and Last Name: Fillable field.

•

E-mail address: Fillable field.

•

State: Select from a drop-down menu.

•

Organization Name: Fillable field.

•

Type of Organization: Select from a drop-down menu.

•

•

»

Title III-B Attorney

»

Legal Services Corporation Attorney

»

Other Legal Services Attorney

»

Other Elder Law Attorney

»

Other Legal Services Professional

»

Aging and/or Disability Network Professional,

»

Other

Title: Select from a drop-down menu.
»

Executive Director

»

Management

»

Staff Attorney

»

Counselor

»

Other

Please rank the quality of assistance provided in this (Legal Training/Case Consultation/Technical
Assistance): Select one of the following from a drop-down menu.
»

Excellent

»

Good

»

Adequate

»

Needs Improvement

»
•

•

Poor

Did the assistance provided by this (Legal Training/Case Consultation/Technical Assistance) contribute
to a successful resolution of a specific client issue? Select one of the following from a drop-down menu.
»

Strongly Agree

»

Agree

»

Agree Somewhat

»

Disagree

»

Strongly Disagree

If requesting assistance on legal services delivery, will the assistance provided contribute to the
successful completion of one or more of the following: legal needs and capacity assessments, legal
services delivery plans, legal service delivery standards, or data collection/reporting systems? Select
one of the following from a drop-down menu.
»

Strongly Agree

»

Agree

»

Agree Somewhat

»

Disagree

»

Strongly Disagree

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless such collection displays a valid OMB control number (OMB 0985-0060). Public reporting
burden for this collection of information is estimated to average 2-5 minutes per response, including time for
gathering and maintaining the data needed and completing and reviewing the collection of information.

Center on Law & Elder Rights |

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File Typeapplication/pdf
File Modified2021-12-20
File Created2021-12-20

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