Attachment F - 2025 NCA NOK State Tribal Survey Eng.pdf

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 2900-0571, and it expires 09/30/2026.

Public reporting burden for this collection of information is estimated to average 20 minutes per respondent, per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate and any other aspect of this collection of information, including suggestions for reducing the burden, to VA Reports Clearance Officer at VACOPaperworkReduAct@va.gov. Please refer to OMB Control No. 2900-0571 in any correspondence. Do not send your completed VA Survey to this email address.

The information you supply will be confidential and protected by the Privacy Act of 1974 (5 U.S.C. 522a) and the VA’s confidentiality statute (38 U.S.C. 5701) as implemented by 38 CFR 1.526(a) and 38 CFR 1.576(b). Disclosure of information involves releases of statistical data and other non-identifying data for the improvement of services within the National Cemetery Administration and for associated administrative purposes.

If you have any questions or concerns, please contact the Survey Help Line at 1-833-231-7069 or email VistraResearch@ConsultVistra.com.

NATIONAL CEMETERY ADMINISTRATION

293997-3

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OMB Control Number 2900-0571 Estimated Completion Time: 20 Minutes

U.S. DEPARTMENT OF VETERANS AFFAIRS

NATIONAL CEMETERY ADMINISTRATION

STATE, TRIBAL OR TERRITORIAL VETERANS CEMETERIES:

2025 NEXT OF KIN/FAMILY MEMBER SATISFACTION SURVEY

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BARCODE

Marking Instructions

The survey will take about 20 minutes to complete. Please read each question carefully before making your response. You may complete the survey on-line using the link address noted on the cover letter (https://bit.ly/STVC2025) or by using the enclosed paper copy in this mailing. To access the survey on-line, enter your unique survey ID code ([MasterID]) on the main screen.

Correct Mark Incorrect Marks

• Use pencil or pen. Make heavy dark marks that fill the circles completely. If you wish to change an answer, erase cleanly (pencil) or put an “X” over the incorrect response (pen).

• Fill in one answer circle for each question unless it states “Mark all that apply.”

• When you are finished, please place the questionnaire in the enclosed postage-paid envelope and put it in the mail.

Please complete this survey based on your experiences at the state, tribal or territorial VA-funded Veterans cemetery where your loved one was interred.

1. Why did you choose to inter your loved one in a state, tribal or territorial Veterans cemetery?

(Mark all that apply)

My loved one wanted to be interred in a state, tribal or territorial Veterans cemetery My loved one wanted to be close to other relatives or friends already buried in the cemetery

The cemetery location will make it easy to visit my loved one’s gravesite It was a more affordable burial option The cemetery’s reputation in the local Veteran Community It was recommended by a VA outreach officer and/or at a VA outreach event It was recommended by the funeral director It was recommended by someone I trust (e.g.

friend, relative, Veterans Service Officer, etc.)

Other (specify): ________________________

2. Prior to your time of need, were you aware of the benefits related to burial in a state, tribal or territorial Veterans cemetery?

Yes No GO TO QUESTION #4

3. How did you learn of these benefits prior to your time of need? (Mark all that apply)

Family member/friends Funeral home Military discharge related materials Other Veteran/Active-duty member

VA/NCA/State/Cemetery pamphlet, newsletter, brochure VA/NCA/State/Cemetery website

Local news VA/NCA/State/Cemetery public service announcement/advertisement VA/NCA/State/Cemetery social media (Facebook or X, formerly known as Twitter) Other (specify): ________________________

SEE MARKING INSTRUCTIONS ON THE COVER. Correct Mark Incorrect Marks

4. Prior to the time of need, what is the BEST way for the state, tribal or territorial Veterans cemetery to convey information regarding benefits? (Mark only one) E-mail

Newsletter/flyer Local newspaper/television news reports VA/NCA/State/Cemetery social media (Facebook or X, formerly known as Twitter) Professional/military association meetings Other (specify): ______________________

5. Did the funeral director provide information about burial and memorial benefits available for Veterans? (Mark all that apply)

information about either VA burial or memorial benefits

6. Was a committal service held at the state, tribal or territorial Veterans cemetery for your loved one?

GO TO QUESTION #14

No, the committal service was not held

GO TO QUESTION #17

Don’t know/Can’t recall

GO TO QUESTION #17

7. How satisfied were you with the available dates and times offered for the scheduling of your committal service?

Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied

8. To what extent were you informed of the details (e.g. length of service, use of committal shelters) related to the committal service prior to attending the service?

Very informed Somewhat informed Neither informed nor uninformed Somewhat uninformed Very uninformed

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Choosing a State, Tribal or Territorial Veterans Cemetery / Cemetery Support and Interaction / NCA Videos

SEE MARKING INSTRUCTIONS ON THE COVER. Correct Mark Incorrect Marks

9. Prior to the service for your loved one, did you view the NCA videos illustrating different committal service options at state, tribal or territorial Veterans cemeteries?

Yes, the Funeral Director provided it Yes, but it was not provided by the Funeral

Director No GO TO QUESTION #12

10. The video(s) helped me understand the burial process at the state, tribal or territorial Veterans cemetery.

Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree

11. Was your experience at the cemetery similar to the video on service options you viewed?

Yes No

12. At the committal service, did your family have any of the following special needs or requests?

(Mark all that apply) Visit the grave View the burial

Handicapped accommodations No, my family did not have any specific needs or requests GO TO QUESTION #14

13. Was the cemetery able to accommodate these special needs or requests to your satisfaction?

Yes, completely Yes, somewhat No, and I understand why No, and I did not understand why

14. The committal shelter used for the service was private, clean, and free of safety hazards.

Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree

15. If your loved one received military funeral honors, how satisfied were you with the honors received?

My loved one did not receive military funeral honors

16. Overall, how satisfied were you with the committal service at the state, tribal or territorial Veterans cemetery?

17. How many times have you visited the cemetery where your loved one was interred?

1-3 4-6 7-9 10 or more None. I have not visited

18. How far do you reside from the cemetery?

Less than 15 miles 15 to 29 miles 30 to 44 miles 45 to 59 miles 60 to 75 miles More than 75 miles

19. Do any of the following factors limit the number of times you visit the state, tribal or territorial Veterans cemetery where your loved one is interred? (Mark all that apply)

Distance to the cemetery Access to transportation Health status Other (specify): ________________________ None of these factors limit my visits

20. Overall, how satisfied were you with the information provided throughout your experience with the state, tribal or territorial Veterans cemetery?

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21. Looking back at your overall experiences with the state, tribal or territorial Veterans cemetery, which items would you have liked more information about? (Mark all that apply) None. I was well informed Details of the committal service Floral policy Military funeral honors Headstone or marker inscription options

Layout of the cemetery (Maps) Timeline of replacement of headstone/marker Directions to cemetery Other (specify): ______________________

22. Please add any comments regarding information about the process or support you received from the state, tribal or territorial Veterans cemetery you would like to share with NCA.

Headstones, Markers or Columbarium Niche Covers

23. Were the inscription options for the headstone, marker, or columbarium niche cover explained to you?

Yes No Not sure/Don’t know

24. Did you feel you had sufficient time to make a decision on the headstone, marker, or columbarium niche cover inscription?

Yes No

25. How satisfied were you with the amount of time it took for the permanent headstone, marker, or columbarium niche cover to be placed?

yet arrived GO TO QUESTION #28

26. Overall, how satisfied were you with the quality and appearance of the headstone, marker, or columbarium niche cover when it arrived?

27. When the headstone, marker, or columbarium niche cover arrived, was the inscription accurate?

Yes No Don’t know/Haven’t seen

If your loved one was NOT a Veteran, please go to Question #31

28. Did you receive a certificate signed by the President of the United States honoring the Veteran’s service?

Yes No GO TO QUESTION #31 Don’t know GO TO QUESTION #31

For information about the Presidential Memorial Certificate (the certificate signed by the President of the United States honoring the Veteran’s service) or to order more copies, please visit our website at www.cem.va.gov/pmc.asp

29. How satisfied were you with the quality of the certificate signed by the President of the United States honoring the Veteran’s service?

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The Presidential Memorial Certificate, the Veterans Legacy Memorial and the NCA Pre-Need Eligibility Registration Process

30. Why were you not satisfied with the quality of the certificate signed by the President of the United States honoring the Veteran’s service?

(Mark all that apply) Envelope was bent/torn Name was misspelled Poor print quality Other (specify): ________________________

31. Are you aware of the Veterans Legacy Memorial

(VLM) website www.vlm.cem.va.gov ?

Yes, and I have visited the site Yes, but I have not visited the site GO TO

QUESTION #35

No. This is the first I have heard of it GO TO

QUESTION #35

32. How easy was the VLM site to navigate?

Very easy Easy Neither easy nor difficult Difficult Very difficult

33. Have you added content to a Veteran page on the VLM site? (Mark all that apply) Yes No. The content submission process was too difficult

No. Other (specify): ____________________

34. How did you become aware of the Veterans Legacy Memorial website? (Mark all that apply) News Article Social Media Email or Text from VA about VLM Email from VLM that Veteran’s VLM Page has been created VLM QR Code Cemetery Staff

NCA/VA/State/Cemetery Event Veteran Service Organization Word of Mouth from family, friends, co-workers, etc.

Other (specify): ________________________ I was not previously aware of the Veterans Legacy Memorial platform

35. Are you aware of the NCA Pre-Need Eligibility process?

Yes No GO TO QUESTION #39

36. How did you first become aware of the Pre-Need opportunity? (Mark only one) Family member/friends Funeral home Military discharge related materials Other Veteran/Active-duty member

VA/NCA/State/Cemetery pamphlet, newsletter, brochure VA/NCA/State/Cemetery website

Local news VA/NCA/State/Cemetery public service announcement/advertisement VA/NCA/State/Cemetery social media (Facebook or X, formerly known as Twitter) Other (specify): ______________________

37. Have you applied for Pre-Need Eligibility?

Yes No GO TO QUESTION #39

38. Were you satisfied with the length of time it took to receive a certificate of eligibility?

Yes No Have not received yet

39. Do you have any additional comments on the headstone, marker or niche cover, the Presidential Memorial Certificate, the Veterans Legacy Memorial or the NCA Pre-Need Eligibility process?

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40. The upkeep of the headstones, markers, or columbarium niche covers is excellent

41. There are sufficient signs within the state, tribal or territorial Veterans cemetery to assist visitors

42. The quality of service received from the state, tribal or territorial Veterans cemetery staff is excellent

43. The state, tribal or territorial Veterans cemetery staff was courteous

44. The state, tribal or territorial Veterans cemetery staff was professional in terms of being knowledgeable, helpful, and responsive

45. The appearance of my loved one’s gravesite/columbarium is excellent

46. The information kiosks (i.e., gravesite locators) are helpful to me.

47. The overall appearance of the state, tribal or territorial Veterans cemetery is excellent

48. Overall, I am satisfied with my experience at the state, tribal or territorial Veterans cemetery

49. The state, tribal or territorial Veterans cemetery honors all Veterans and their service to our nation

50. I would recommend the state, tribal or territorial Veterans cemetery to Veteran families during their time of need

51. I trust the state, tribal or territorial Veterans cemetery to meet the burial needs of Veterans in the future

52. I trust the state, tribal or territorial governments to maintain their cemeteries as national shrines in the future

53. My experiences with the state, tribal or territorial Veterans cemetery exceeded my expectations

For the following series of statements please indicate your level of agreement.

St ro ng ly ag re e

Ne ith er a gr ee no r d isa gr ee

Di sa gr ee

Ag re e

St ro ng ly di sa gr ee

Do n’ t k w/ t a pp lic ab le

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58. Based on your visit, the quality of service at the state, tribal or territorial Veterans cemetery compares favorably to the VA national cemetery.

Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree

59. The honor of being interred at a state, tribal or territorial Veterans cemetery is equivalent to that of being interred at a VA national cemetery.

Strongly agree Agree Neither agree nor disagree Disagree

60. Are you aware of the PACT Act (The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act) and the expanded eligibility of VA health care for Veterans with toxic exposure?

Yes No Don’t know what this is

Demographics Disclaimer Statement:

much data and information as possible. Your responses will not be connected to you as an individual. These responses will help improve customer experience, approved research, and the quality of care and services for all Veterans. They

VA follows strict security and privacy practices and

61. Was your loved one your...

Spouse Partner Parent Child Other relative Not a relative

62. Are you a Veteran?

Yes No GO TO QUESTION #64

State, tribal or territorial Veterans cemeteries are complements to VA’s national cemeteries that are expected to be maintained and operated in a way befitting a national shrine, as are VA’s national cemeteries operated by the Federal Government.

Your answers to these questions will help us determine how well we are doing that.

54. Had I been able, I would have chosen to inter my loved one at a VA national cemetery rather than the state, tribal or territorial Veterans cemetery.

Strongly agree Agree Neither agree nor disagree GO TO

QUESTION #56

Disagree GO TO QUESTION #56 Strongly disagree GO TO QUESTION #56

55. Please choose any of the following reasons to describe why you would have preferred interment in a VA national cemetery rather than a state, tribal or territorial Veterans cemetery. (Mark all that apply)

My loved one wanted to be interred in a VA national cemetery

Other family members are interred in a VA national cemetery

Others recommended the VA national cemetery

There is no cost to inter my loved one at a national cemetery

A national cemetery is more prestigious than a state, tribal or territorial Veterans cemetery

The appearance and quality of service at a national cemetery is superior to the appearance and quality of service at a state, tribal or territorial Veterans cemetery

Other (specify): ______________________

56. Have you visited a VA national cemetery?

Yes No GO TO QUESTION #59 Don’t know/Not applicable GO TO

QUESTION #59

57. Based on your visit, the appearance of the state, tribal or territorial Veterans cemetery compares favorably to the VA national cemetery.

Strongly agree

Agree Neither agree nor disagree Disagree Strongly disagree

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69. What is your race and/or ethnicity?

(Mark all that apply)

American Indian or Alaska Native For example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.

Asian For example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, Japanese, etc.

Black or African American For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc.

Hispanic or Latino For example, Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, etc.

Middle Eastern or North African For example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, Israeli, etc.

Native Hawaiian or Pacific Islander For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc.

White For example, English, German, Irish, Italian, Polish, Scottish, etc.

70. Have you or your loved one used any other VA Benefits? (Mark all that apply) Have not used other VA benefits

Housebound Allowance Aid and Attendance VA Life Insurance Pension Education benefits Other (specify): ______________________

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63. Are you a Veteran married/partnered to a Veteran?

Yes No

Please note: Veterans who are married to Veterans are entitled to individual gravesite and headstone/marker/medallion benefits.

Visit www.va.gov/burials-memorials/eligibility/ for more information.

64. What is your sex?

Female Male

65. Was your loved one female or male?

Female Male

66. What language do you mainly speak at home?

English Spanish Chinese Tagalog Vietnamese Arabic Some other language (specify): ________

67. In what year were you born?

68. In what belief tradition was the burial conducted?

Christian Catholic Muslim Jewish Buddhist Hindu Atheist Agnostic None Other (specify): ______________________ Choose not to answer

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71. Please use this space to elaborate on any additional aspects of your experience at the state, tribal or territorial Veterans cemetery you would like to share with the NCA.

72. Are you willing to participate in a Focus Group discussion?

No

complete the information below:

In what way would you be willing to participate in the focus group? (Mark all that apply) Online By phone In person at a focus group facility

Name: _______________________________

Phone Number: ________________________

Email: _______________________________

Your participation will have no impact on your VA benefits.

Thank you very much for taking the time to complete this questionnaire.

PLEASE mail this completed questionnaire in the enclosed pre-paid envelope as soon as possible.

If you misplaced the pre-paid envelope, you may mail the completed survey to the following address using your own envelope:

NATIONAL CEMETERY ADMINISTRATION

PO BOX 510570

LIVONIA, MI 48151-9807

If you have any questions about this research, please contact the Survey Help Line at 1-833-231-7069 or email VistraResearch@ConsultVistra.com.

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