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Submission: On May 04 via api from US — Scanned from DE
Submission: On May 04 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: surveyform — POST /?ettb5k78th5wc5tsp93nht
<form name="surveyform" action="/?ettb5k78th5wc5tsp93nht" method="post"><!-- react-empty: 4 -->
<div><!-- react-empty: 6 --><input type="hidden" name="is_embedded" id="is_embedded" value="false">
<header><a class="layout_skipNav" href="#content">Skip to Content</a>
<div class="layout_layoutContainer">
<div class="layout_mainHeader layout_clearfix">
<div class="layout_mainHeaderLeft">
<h1 class="layout_invisibleTitle" tabindex="0" aria-label="Survey"></h1><img class="layout_logo" src="https://sb-static.voice.va.gov/abbe49dc0e375d6fde5b6ea482ed0400e9255cba" alt="U.S. Department of Veterans Affairs Logo">
</div>
<div class="layout_mainHeaderRight"><span id="languageSelector" class=""><!-- react-empty: 17 --><input type="hidden" name="lang" id="activeLang" value="en"></span></div>
</div>
</div>
</header>
<div class="layout_layoutContainer"><input type="hidden" name="stay_main-pager" value="0"><input type="hidden" name="nodeId" value="survey-fe2"><input type="hidden" name="ballotVer" value="13"><input type="hidden" name="currentPage"
value="0"><input type="hidden" name="defPgrAction" value="next"><!-- react-empty: 25 --></div>
<div role="main" id="content" class="layout_layoutContainer layout_layoutContainer_fadeInUp">
<div class="htmlBlock"></div>
<div class="htmlBlock">
<div class="layout_text textNode">
<div style="display:block; clear:none; margin-bottom: 40px;">
<div style="display: block; float: left; text-align: left; font-size: 13px; clear: none; line-height: 1.3em; width: 67%;">
<p>The VA provides free, confidential support 24/7 for Veterans and their family and friends. If you are in crisis, contact the <b>Veterans Crisis Line</b> by dialing 1 (800) 273-8255 (Press 1), or texting 838255, or visiting
<a href="https://www.veteranscrisisline.net" target="_blank">https://www.veteranscrisisline.net</a>. If you are homeless or at risk of homelessness, contact the <b>National Call Center for Homeless Veterans (NCCHV)</b> by dialing 1
(877) 424-3838 or visiting <a href="https://www.va.gov/HOMELESS/" target="_blank">https://www.va.gov/HOMELESS/</a>.</p>
</div>
<div style="display: block; float: right; text-align: left; font-size: 13px; clear: none; line-height: 1.3em; width: 25%;">
<p> OMB Number: 2900-0876 <br> Expiration: 03/31/2023 <br> Estimated Burden: 4 minutes </p>
</div>
</div>
</div>
</div>
<div class="htmlBlock">
<div class="layout_text textNode" style="clear:left;">
<br>
<span style="font-size: 40px;"><strong>Help us serve you better.</strong></span>
<br>
<br>
<span style="font-size: 22px;"> We want to hear about your recent interaction with the ChampVA (CSC). By indicating how much you agree or disagree with the statements below, you directly help us improve VA services. </span>
<br>
<br>
<span style="font-size: 17px;"> This survey should take you approximately 4 minutes to complete. </span>
<br>
</div>
</div>
<fieldset class="questionBlock ratingGridQuestion ratingGridQuestion_hasOneRow">
<legend class="question_questionTitle" id="3"><span class="questionCaption"><b>I waited a reasonable amount of time to speak to a customer service representative.</b> <u>Required</u></span></legend>
<div class="layout_answers">
<div class="table_table rowOption_rowOptionContainer ratingGridRow">
<div aria-hidden="true" class="row_row">
<div class="cell_cell rowOption_anchorsContainer">
<div class="table_table anchors anchors_isFirstRow table_table_hasFixedLayout">
<div class="row_row">
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Neither Agree nor Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Agree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Agree</span></div>
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</div>
</div>
<div class="row_row">
<div class="cell_cell">
<div class="rowOption_selectionUnits">
<div class="table_table selectionBar_selectionBarContainer table_table_hasFixedLayout">
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<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_waited_scale5_1"
aria-describedby="3 3_onf_q_va_eccc_occc_standard_waited_scale5___2tQ8c1" aria-label="1 Strongly Disagree" class="cellOption_input" data-mds-value="1" data-representative-value="1"
name="onf_q_va_eccc_occc_standard_waited_scale5" value="1">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">1</span>
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<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_waited_scale5_2"
aria-describedby="3 3_onf_q_va_eccc_occc_standard_waited_scale5___2tQ8c1" aria-label="2 Disagree" class="cellOption_input" data-mds-value="2" data-representative-value="2" name="onf_q_va_eccc_occc_standard_waited_scale5"
value="2">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">2</span>
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</div>
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</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_waited_scale5_3"
aria-describedby="3 3_onf_q_va_eccc_occc_standard_waited_scale5___2tQ8c1" aria-label="3 Neither Agree nor Disagree" class="cellOption_input" data-mds-value="3" data-representative-value="3"
name="onf_q_va_eccc_occc_standard_waited_scale5" value="3">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">3</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_waited_scale5_4"
aria-describedby="3 3_onf_q_va_eccc_occc_standard_waited_scale5___2tQ8c1" aria-label="4 Agree" class="cellOption_input" data-mds-value="4" data-representative-value="4" name="onf_q_va_eccc_occc_standard_waited_scale5"
value="4">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">4</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_waited_scale5_5"
aria-describedby="3 3_onf_q_va_eccc_occc_standard_waited_scale5___2tQ8c1" aria-label="5 Strongly Agree" class="cellOption_input" data-mds-value="5" data-representative-value="5"
name="onf_q_va_eccc_occc_standard_waited_scale5" value="5">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">5</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset class="questionBlock ratingGridQuestion ratingGridQuestion_hasOneRow">
<legend class="question_questionTitle" id="4"><span class="validation_validationBlock validationMessage validation_requiredBlock"><i aria-hidden="true" class="medallicons_medallicons validation_validationIcon"></i><span
class="validation_caption">Required</span></span><span class="questionCaption"><b>It was easy to reach the right person about my need.</b> <u>Required</u></span></legend>
<div class="layout_answers">
<div class="table_table rowOption_rowOptionContainer ratingGridRow">
<div aria-hidden="true" class="row_row">
<div class="cell_cell rowOption_anchorsContainer">
<div class="table_table anchors anchors_isFirstRow table_table_hasFixedLayout">
<div class="row_row">
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Neither Agree nor Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Agree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Agree</span></div>
</div>
</div>
</div>
</div>
<div class="row_row">
<div class="cell_cell">
<div class="rowOption_selectionUnits">
<div class="table_table selectionBar_selectionBarContainer table_table_hasFixedLayout">
<div class="row_row">
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_ease_reach_scale5_1" aria-required="true"
aria-describedby="4 4_onf_q_va_eccc_standard_ease_reach_scale5___h4Rphy" aria-label="1 Strongly Disagree" class="cellOption_input" data-mds-value="1" data-representative-value="1"
name="onf_q_va_eccc_standard_ease_reach_scale5" value="1">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">1</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_ease_reach_scale5_2" aria-required="true"
aria-describedby="4 4_onf_q_va_eccc_standard_ease_reach_scale5___h4Rphy" aria-label="2 Disagree" class="cellOption_input" data-mds-value="2" data-representative-value="2" name="onf_q_va_eccc_standard_ease_reach_scale5"
value="2">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">2</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_ease_reach_scale5_3" aria-required="true"
aria-describedby="4 4_onf_q_va_eccc_standard_ease_reach_scale5___h4Rphy" aria-label="3 Neither Agree nor Disagree" class="cellOption_input" data-mds-value="3" data-representative-value="3"
name="onf_q_va_eccc_standard_ease_reach_scale5" value="3">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">3</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_ease_reach_scale5_4" aria-required="true"
aria-describedby="4 4_onf_q_va_eccc_standard_ease_reach_scale5___h4Rphy" aria-label="4 Agree" class="cellOption_input" data-mds-value="4" data-representative-value="4" name="onf_q_va_eccc_standard_ease_reach_scale5"
value="4">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">4</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_ease_reach_scale5_5" aria-required="true"
aria-describedby="4 4_onf_q_va_eccc_standard_ease_reach_scale5___h4Rphy" aria-label="5 Strongly Agree" class="cellOption_input" data-mds-value="5" data-representative-value="5"
name="onf_q_va_eccc_standard_ease_reach_scale5" value="5">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">5</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset class="questionBlock ratingGridQuestion ratingGridQuestion_hasOneRow">
<legend class="question_questionTitle" id="5"><span class="questionCaption"><b>The customer service representative took a reasonable amount of time to address my need.</b> <u>Required</u></span></legend>
<div class="layout_answers">
<div class="table_table rowOption_rowOptionContainer ratingGridRow">
<div aria-hidden="true" class="row_row">
<div class="cell_cell rowOption_anchorsContainer">
<div class="table_table anchors anchors_isFirstRow table_table_hasFixedLayout">
<div class="row_row">
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Neither Agree nor Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Agree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Agree</span></div>
</div>
</div>
</div>
</div>
<div class="row_row">
<div class="cell_cell">
<div class="rowOption_selectionUnits">
<div class="table_table selectionBar_selectionBarContainer table_table_hasFixedLayout">
<div class="row_row">
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_reasonable_time_scale5_1"
aria-describedby="5 5_onf_q_va_eccc_occc_standard_reasonable_time_scale5___z52Ulq" aria-label="1 Strongly Disagree" class="cellOption_input" data-mds-value="1" data-representative-value="1"
name="onf_q_va_eccc_occc_standard_reasonable_time_scale5" value="1">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">1</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_reasonable_time_scale5_2"
aria-describedby="5 5_onf_q_va_eccc_occc_standard_reasonable_time_scale5___z52Ulq" aria-label="2 Disagree" class="cellOption_input" data-mds-value="2" data-representative-value="2"
name="onf_q_va_eccc_occc_standard_reasonable_time_scale5" value="2">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">2</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_reasonable_time_scale5_3"
aria-describedby="5 5_onf_q_va_eccc_occc_standard_reasonable_time_scale5___z52Ulq" aria-label="3 Neither Agree nor Disagree" class="cellOption_input" data-mds-value="3" data-representative-value="3"
name="onf_q_va_eccc_occc_standard_reasonable_time_scale5" value="3">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">3</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_reasonable_time_scale5_4"
aria-describedby="5 5_onf_q_va_eccc_occc_standard_reasonable_time_scale5___z52Ulq" aria-label="4 Agree" class="cellOption_input" data-mds-value="4" data-representative-value="4"
name="onf_q_va_eccc_occc_standard_reasonable_time_scale5" value="4">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">4</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_reasonable_time_scale5_5"
aria-describedby="5 5_onf_q_va_eccc_occc_standard_reasonable_time_scale5___z52Ulq" aria-label="5 Strongly Agree" class="cellOption_input" data-mds-value="5" data-representative-value="5"
name="onf_q_va_eccc_occc_standard_reasonable_time_scale5" value="5">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">5</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset class="questionBlock ratingGridQuestion ratingGridQuestion_hasOneRow">
<legend class="question_questionTitle" id="6"><span class="questionCaption"><b> I understood the information provided by the customer service representative.</b> <u>Required</u></span></legend>
<div class="layout_answers">
<div class="table_table rowOption_rowOptionContainer ratingGridRow">
<div aria-hidden="true" class="row_row">
<div class="cell_cell rowOption_anchorsContainer">
<div class="table_table anchors anchors_isFirstRow table_table_hasFixedLayout">
<div class="row_row">
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Neither Agree nor Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Agree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Agree</span></div>
</div>
</div>
</div>
</div>
<div class="row_row">
<div class="cell_cell">
<div class="rowOption_selectionUnits">
<div class="table_table selectionBar_selectionBarContainer table_table_hasFixedLayout">
<div class="row_row">
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_info_provided_scale5_1"
aria-describedby="6 6_onf_q_va_eccc_occc_standard_info_provided_scale5___3TMSLf" aria-label="1 Strongly Disagree" class="cellOption_input" data-mds-value="1" data-representative-value="1"
name="onf_q_va_eccc_occc_standard_info_provided_scale5" value="1">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">1</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_info_provided_scale5_2"
aria-describedby="6 6_onf_q_va_eccc_occc_standard_info_provided_scale5___3TMSLf" aria-label="2 Disagree" class="cellOption_input" data-mds-value="2" data-representative-value="2"
name="onf_q_va_eccc_occc_standard_info_provided_scale5" value="2">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">2</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_info_provided_scale5_3"
aria-describedby="6 6_onf_q_va_eccc_occc_standard_info_provided_scale5___3TMSLf" aria-label="3 Neither Agree nor Disagree" class="cellOption_input" data-mds-value="3" data-representative-value="3"
name="onf_q_va_eccc_occc_standard_info_provided_scale5" value="3">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">3</span>
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</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_info_provided_scale5_4"
aria-describedby="6 6_onf_q_va_eccc_occc_standard_info_provided_scale5___3TMSLf" aria-label="4 Agree" class="cellOption_input" data-mds-value="4" data-representative-value="4"
name="onf_q_va_eccc_occc_standard_info_provided_scale5" value="4">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">4</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_info_provided_scale5_5"
aria-describedby="6 6_onf_q_va_eccc_occc_standard_info_provided_scale5___3TMSLf" aria-label="5 Strongly Agree" class="cellOption_input" data-mds-value="5" data-representative-value="5"
name="onf_q_va_eccc_occc_standard_info_provided_scale5" value="5">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">5</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset class="questionBlock ratingGridQuestion ratingGridQuestion_hasOneRow">
<legend class="question_questionTitle" id="7"><span class="questionCaption"><b>The customer service representative I interacted with was helpful.</b> <u>Required</u></span></legend>
<div class="layout_answers">
<div class="table_table rowOption_rowOptionContainer ratingGridRow">
<div aria-hidden="true" class="row_row">
<div class="cell_cell rowOption_anchorsContainer">
<div class="table_table anchors anchors_isFirstRow table_table_hasFixedLayout">
<div class="row_row">
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Neither Agree nor Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Agree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Agree</span></div>
</div>
</div>
</div>
</div>
<div class="row_row">
<div class="cell_cell">
<div class="rowOption_selectionUnits">
<div class="table_table selectionBar_selectionBarContainer table_table_hasFixedLayout">
<div class="row_row">
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_helpful_scale5_1"
aria-describedby="7 7_onf_q_va_eccc_occc_standard_helpful_scale5___Alsa1t" aria-label="1 Strongly Disagree" class="cellOption_input" data-mds-value="1" data-representative-value="1"
name="onf_q_va_eccc_occc_standard_helpful_scale5" value="1">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">1</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_helpful_scale5_2"
aria-describedby="7 7_onf_q_va_eccc_occc_standard_helpful_scale5___Alsa1t" aria-label="2 Disagree" class="cellOption_input" data-mds-value="2" data-representative-value="2" name="onf_q_va_eccc_occc_standard_helpful_scale5"
value="2">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">2</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_helpful_scale5_3"
aria-describedby="7 7_onf_q_va_eccc_occc_standard_helpful_scale5___Alsa1t" aria-label="3 Neither Agree nor Disagree" class="cellOption_input" data-mds-value="3" data-representative-value="3"
name="onf_q_va_eccc_occc_standard_helpful_scale5" value="3">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">3</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_helpful_scale5_4"
aria-describedby="7 7_onf_q_va_eccc_occc_standard_helpful_scale5___Alsa1t" aria-label="4 Agree" class="cellOption_input" data-mds-value="4" data-representative-value="4" name="onf_q_va_eccc_occc_standard_helpful_scale5"
value="4">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">4</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_occc_standard_helpful_scale5_5"
aria-describedby="7 7_onf_q_va_eccc_occc_standard_helpful_scale5___Alsa1t" aria-label="5 Strongly Agree" class="cellOption_input" data-mds-value="5" data-representative-value="5"
name="onf_q_va_eccc_occc_standard_helpful_scale5" value="5">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">5</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset class="questionBlock ratingGridQuestion ratingGridQuestion_hasOneRow">
<legend class="question_questionTitle" id="8"><span class="validation_validationBlock validationMessage validation_requiredBlock"><i aria-hidden="true" class="medallicons_medallicons validation_validationIcon"></i><span
class="validation_caption">Required</span></span><span class="questionCaption"><b>The issue that I contacted the ChampVA (CSC) about on April 27, 2022 was resolved.</b> <u>Required</u></span></legend>
<div class="layout_answers">
<div class="table_table rowOption_rowOptionContainer ratingGridRow">
<div aria-hidden="true" class="row_row">
<div class="cell_cell rowOption_anchorsContainer">
<div class="table_table anchors anchors_isFirstRow table_table_hasFixedLayout">
<div class="row_row">
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Neither Agree nor Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Agree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Agree</span></div>
</div>
</div>
</div>
</div>
<div class="row_row">
<div class="cell_cell">
<div class="rowOption_selectionUnits">
<div class="table_table selectionBar_selectionBarContainer table_table_hasFixedLayout">
<div class="row_row">
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_issue_resolved_scale5_1" aria-required="true"
aria-describedby="8 8_onf_q_va_eccc_standard_issue_resolved_scale5___xVeEz2" aria-label="1 Strongly Disagree" class="cellOption_input" data-mds-value="1" data-representative-value="1"
name="onf_q_va_eccc_standard_issue_resolved_scale5" value="1">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">1</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_issue_resolved_scale5_2" aria-required="true"
aria-describedby="8 8_onf_q_va_eccc_standard_issue_resolved_scale5___xVeEz2" aria-label="2 Disagree" class="cellOption_input" data-mds-value="2" data-representative-value="2"
name="onf_q_va_eccc_standard_issue_resolved_scale5" value="2">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">2</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_issue_resolved_scale5_3" aria-required="true"
aria-describedby="8 8_onf_q_va_eccc_standard_issue_resolved_scale5___xVeEz2" aria-label="3 Neither Agree nor Disagree" class="cellOption_input" data-mds-value="3" data-representative-value="3"
name="onf_q_va_eccc_standard_issue_resolved_scale5" value="3">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">3</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_issue_resolved_scale5_4" aria-required="true"
aria-describedby="8 8_onf_q_va_eccc_standard_issue_resolved_scale5___xVeEz2" aria-label="4 Agree" class="cellOption_input" data-mds-value="4" data-representative-value="4"
name="onf_q_va_eccc_standard_issue_resolved_scale5" value="4">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">4</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_issue_resolved_scale5_5" aria-required="true"
aria-describedby="8 8_onf_q_va_eccc_standard_issue_resolved_scale5___xVeEz2" aria-label="5 Strongly Agree" class="cellOption_input" data-mds-value="5" data-representative-value="5"
name="onf_q_va_eccc_standard_issue_resolved_scale5" value="5">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">5</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset class="questionBlock ratingGridQuestion ratingGridQuestion_hasOneRow">
<legend class="question_questionTitle" id="9"><span class="validation_validationBlock validationMessage validation_requiredBlock"><i aria-hidden="true" class="medallicons_medallicons validation_validationIcon"></i><span
class="validation_caption">Required</span></span><span class="questionCaption"><b>I am satisfied with the service I received from the ChampVA (CSC).</b> <u>Required</u></span></legend>
<div class="layout_answers">
<div class="table_table rowOption_rowOptionContainer ratingGridRow">
<div aria-hidden="true" class="row_row">
<div class="cell_cell rowOption_anchorsContainer">
<div class="table_table anchors anchors_isFirstRow table_table_hasFixedLayout">
<div class="row_row">
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Neither Agree nor Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Agree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Agree</span></div>
</div>
</div>
</div>
</div>
<div class="row_row">
<div class="cell_cell">
<div class="rowOption_selectionUnits">
<div class="table_table selectionBar_selectionBarContainer table_table_hasFixedLayout">
<div class="row_row">
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_satisfaction_scale5_1" aria-required="true"
aria-describedby="9 9_onf_q_va_eccc_standard_satisfaction_scale5___JeBlOV" aria-label="1 Strongly Disagree" class="cellOption_input" data-mds-value="1" data-representative-value="1"
name="onf_q_va_eccc_standard_satisfaction_scale5" value="1">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">1</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_satisfaction_scale5_2" aria-required="true"
aria-describedby="9 9_onf_q_va_eccc_standard_satisfaction_scale5___JeBlOV" aria-label="2 Disagree" class="cellOption_input" data-mds-value="2" data-representative-value="2" name="onf_q_va_eccc_standard_satisfaction_scale5"
value="2">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">2</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_satisfaction_scale5_3" aria-required="true"
aria-describedby="9 9_onf_q_va_eccc_standard_satisfaction_scale5___JeBlOV" aria-label="3 Neither Agree nor Disagree" class="cellOption_input" data-mds-value="3" data-representative-value="3"
name="onf_q_va_eccc_standard_satisfaction_scale5" value="3">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">3</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_satisfaction_scale5_4" aria-required="true"
aria-describedby="9 9_onf_q_va_eccc_standard_satisfaction_scale5___JeBlOV" aria-label="4 Agree" class="cellOption_input" data-mds-value="4" data-representative-value="4" name="onf_q_va_eccc_standard_satisfaction_scale5"
value="4">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">4</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_satisfaction_scale5_5" aria-required="true"
aria-describedby="9 9_onf_q_va_eccc_standard_satisfaction_scale5___JeBlOV" aria-label="5 Strongly Agree" class="cellOption_input" data-mds-value="5" data-representative-value="5"
name="onf_q_va_eccc_standard_satisfaction_scale5" value="5">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">5</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset class="questionBlock ratingGridQuestion ratingGridQuestion_hasOneRow">
<legend class="question_questionTitle" id="10"><span class="validation_validationBlock validationMessage validation_requiredBlock"><i aria-hidden="true" class="medallicons_medallicons validation_validationIcon"></i><span
class="validation_caption">Required</span></span><span class="questionCaption"><b>I trust VA to fulfill our country's commitment to Veterans.</b> <u>Required</u></span></legend>
<div class="layout_answers">
<div class="table_table rowOption_rowOptionContainer ratingGridRow">
<div aria-hidden="true" class="row_row">
<div class="cell_cell rowOption_anchorsContainer">
<div class="table_table anchors anchors_isFirstRow table_table_hasFixedLayout">
<div class="row_row">
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Neither Agree nor Disagree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Agree</span></div>
<div aria-hidden="true" class="cell_cell anchor anchor_customStyles anchor_5column anchor_isOnFirstRow"><span>Strongly Agree</span></div>
</div>
</div>
</div>
</div>
<div class="row_row">
<div class="cell_cell">
<div class="rowOption_selectionUnits">
<div class="table_table selectionBar_selectionBarContainer table_table_hasFixedLayout">
<div class="row_row">
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_trust_scale5_1" aria-required="true"
aria-describedby="10 10_onf_q_va_eccc_standard_trust_scale5___a93PB5" aria-label="1 Strongly Disagree" class="cellOption_input" data-mds-value="1" data-representative-value="1" name="onf_q_va_eccc_standard_trust_scale5"
value="1">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">1</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_trust_scale5_2" aria-required="true"
aria-describedby="10 10_onf_q_va_eccc_standard_trust_scale5___a93PB5" aria-label="2 Disagree" class="cellOption_input" data-mds-value="2" data-representative-value="2" name="onf_q_va_eccc_standard_trust_scale5" value="2">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">2</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_trust_scale5_3" aria-required="true"
aria-describedby="10 10_onf_q_va_eccc_standard_trust_scale5___a93PB5" aria-label="3 Neither Agree nor Disagree" class="cellOption_input" data-mds-value="3" data-representative-value="3"
name="onf_q_va_eccc_standard_trust_scale5" value="3">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">3</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_trust_scale5_4" aria-required="true"
aria-describedby="10 10_onf_q_va_eccc_standard_trust_scale5___a93PB5" aria-label="4 Agree" class="cellOption_input" data-mds-value="4" data-representative-value="4" name="onf_q_va_eccc_standard_trust_scale5" value="4">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">4</span>
</div>
</div>
</div>
</div>
<div class="cell_cell selectionBar_selectionUnit layout_answer">
<div class="cellOption_cellOptionContainer" data-has-answer="false" data-should-display-as-selected="false"><input type="radio" id="onf_q_va_eccc_standard_trust_scale5_5" aria-required="true"
aria-describedby="10 10_onf_q_va_eccc_standard_trust_scale5___a93PB5" aria-label="5 Strongly Agree" class="cellOption_input" data-mds-value="5" data-representative-value="5" name="onf_q_va_eccc_standard_trust_scale5"
value="5">
<div aria-hidden="true" class="cellOption_indicatorContainer">
<div aria-hidden="true" class="indicatorCircle_indicatorCircleContainer indicatorCircle">
<div class="indicatorCircle_circle"></div><span class="indicatorCircle_label">5</span>
</div>
</div>
</div>
</div>
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than what has been authorized under the Privacy Act of 1974. Your response is voluntary. Giving us your information is voluntary. Refusal to provide your information will not result in the denial of benefits. VA will not deny an
individual benefits for refusing to provide information asked within this survey. The responses you submit are considered confidential (38 U.S.C. 5701). Information submitted is subject to verification through computer matching
programs with other agencies. This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor and you are not required to respond to, a collection of
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Skip to Content The VA provides free, confidential support 24/7 for Veterans and their family and friends. If you are in crisis, contact the Veterans Crisis Line by dialing 1 (800) 273-8255 (Press 1), or texting 838255, or visiting https://www.veteranscrisisline.net. If you are homeless or at risk of homelessness, contact the National Call Center for Homeless Veterans (NCCHV) by dialing 1 (877) 424-3838 or visiting https://www.va.gov/HOMELESS/. OMB Number: 2900-0876 Expiration: 03/31/2023 Estimated Burden: 4 minutes Help us serve you better. We want to hear about your recent interaction with the ChampVA (CSC). By indicating how much you agree or disagree with the statements below, you directly help us improve VA services. This survey should take you approximately 4 minutes to complete. I waited a reasonable amount of time to speak to a customer service representative. Required Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree 1 2 3 4 5 RequiredIt was easy to reach the right person about my need. Required Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree 1 2 3 4 5 The customer service representative took a reasonable amount of time to address my need. Required Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree 1 2 3 4 5 I understood the information provided by the customer service representative. Required Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree 1 2 3 4 5 The customer service representative I interacted with was helpful. Required Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree 1 2 3 4 5 RequiredThe issue that I contacted the ChampVA (CSC) about on April 27, 2022 was resolved. Required Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree 1 2 3 4 5 RequiredI am satisfied with the service I received from the ChampVA (CSC). Required Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree 1 2 3 4 5 RequiredI trust VA to fulfill our country's commitment to Veterans. Required Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree 1 2 3 4 5 RequiredCan VA contact you about your feedback? Required * Yes, VA can contact me about my experience. * No, I do not want VA to contact me about my experience. Would you like to volunteer your demographic information to help VA better serve you? * Yes * No Next We are asking for this information so that you can provide compliments, recommendations, or concerns to VAReadjustment Counseling Service (RCS) Vet Centers. By filling out this survey, you are authorizing VARCS Vet Centers database access to retrieve Veteran contact information to follow up with you accordingly for purposes of service recovery, potential crisis, or to learn more about feedback you have shared regarding your experience with VARCS Vet Centers. Your contact information and response may be referred to the Veterans Crisis Line if an automated review indicates your response may be concerning. The Veterans Crisis Line may contact you for follow up as a result of that referral. VARCS Vet Centers may utilize individual Veteran survey data from this survey or other sources to ensure the final scores truly and accurately represent the experiences of Veterans. This survey is used to inform Congressional legislation and budgets to help the VA better serve Veterans with educational assistance. The information gathered from this survey will be maintained and stored in a secure survey platform. VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974. Your response is voluntary. Giving us your information is voluntary. Refusal to provide your information will not result in the denial of benefits. VA will not deny an individual benefits for refusing to provide information asked within this survey. The responses you submit are considered confidential (38 U.S.C. 5701). Information submitted is subject to verification through computer matching programs with other agencies. This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who complete this survey will average The Center for Women Veterans is exempt from the Paperwork Reduction Act as found in the Public Law (P.L.) 103 section 509, 318(d). This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 1 minute2 minutes3 minutes4 minutes5 minutes6 minutes to review the instructions and complete this survey. The results of this survey will be used to inform opportunities for program improvement in the quality of VARCS Vet Centers services. Participation in this survey is voluntary, and your decision not to respond will have no impact on VA benefitsVA or RCS Vet Centers confidentiality, benefits or services which you may currently be receiving. . This includes the time it will take to follow instructions, gather the necessary facts and respond to questions asked. Customer satisfaction is used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this survey will lead to improvements in the quality of service delivery by helping to improve educational assistance programs. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled.VARCS Vet Centers cannot conduct or sponsor a collection of information unless a valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid OMB control numbers can be located on the OMB Internet Page at https://www.reginfo.gov/public/do/PRAMain. Information gathered will be kept private to the extent provided by law. Privacy Policy If you have additional questions or concerns, please reach out to the Veterans Experience Office.