Information Collection

Patient Satisfaction Survey/food Service And Nutritional Care Analysis

IC 174548 under ICR 199107-2900-017 · OMB 2900-0227.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0227 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

PATIENT SATISFACTION SURVEY/FOOD SERVICE AND NUTRITIONAL CARE ANALYSIS

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	10-1465 D	No	No
Form	THROUGH	No	No
Form	F & 10-5387	No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 608,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	745,600	137,600	608,000
Annual IC Time Burden (Hours)	106,123	4,587	101,536
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.