generic_clearance_form 6 11 2009

SUBMISSION OF INFORMATION COLLECTION

UNDER GENERIC CLEARANCES

DATE OF REQUEST: _June 17, 2009

SUB AGENCY (I/C): ___NCCAM____________

TITLE: ___NCCAM Newsletter________________

GENERIC CLEARANCE UNDER OMB# ­_0925-0530___ EXP. DATE: _10/31/2010_____

ABSTRACT:

The NCCAM newsletter is a fundamental tool for providing complementary and alternative medical information to consumers. A survey placed in the newsletter would provide the necessary feedback to the newsletter content to be tailored to the subscribers’ needs. The responses would allow NCCAM to gauge what features and topics the consumers are most interested in, construct ideal formats, and determine preferred delivery methods.

All subscribers and visitors to the newsletter page on NCCAM’s web site will be asked to complete a brief survey regarding newsletter preferences. The survey can either be completed online or returned via USPS with a prepaid-postage envelope. Completion will be voluntary with no payment and individual responses will be kept confidential. Findings will be used by NCCAM for program planning purposes and published or otherwise shared externally.

TOTAL ANNUAL BURDEN APPROVED: _712_________

BURDEN USED TO DATE: ___60_______

BURDEN THIS REQUEST: _20_________

IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?

______YES ___x___NO______N/A

OBLIGATION TO RESPOND:

__x____ VOLUNTARY

______ REQUIRED TO OBTAIN OR RETAIN BENEFITS

______ MANDATORY

HOW WILL THIS SURVEY BE OFFERED?

__x___ WEB SITE

_____ TELEPHONE INTERVIEW

__x___ MAIL RESPONSE

_____ IN PERSON INTERVIEW

_____ OTHER: _

CONTACT INFORMATION:

NAME: __ Alyssa Cotler _________________________________________

TELEPHONE NUMBER: _301-451-3851___________________________

EMAIL ADDRESS: _ [email protected] ________________________