Pilot of a Survey Instrument Designed to Assess Users' Perceptions of Website Changes (Sub-Study #2)

Questionnaire Cognitive Interviewing and Pretesting (NCI)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0589 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Pilot of a Survey Instrument Designed to Assess Users' Perceptions of Website Changes (Sub-Study #2) Form
1 Survey to Evaluate Changes to Website Design Attachment 1_ARP Survey-0925-0589-02.doc Form
GC Sub-Study Summary Form.doc Generic Sub-Study Summary IC Document
Memo_0925-0589-02_DCCPS ARP Survey_3-12-09.doc Memo/Justification for 0925-0589-02 IC Document

Information Collection (IC) Details

IC Title:	Pilot of a Survey Instrument Designed to Assess Users' Perceptions of Website Changes (Sub-Study #2)	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	Survey to Evaluate Changes to Website Design	Attachment 1_ARP Survey-0925-0589-02.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 100	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	100	0	0	0	0	0
Annual IC Time Burden (Hours)	5	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Sub-Study Summary	GC Sub-Study Summary Form.doc	03/12/2009
Memo/Justification for 0925-0589-02	Memo_0925-0589-02_DCCPS ARP Survey_3-12-09.doc	03/12/2009

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