New Freedom Initiative Caregiver Broadcast Survey

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Document Name Document Type
Form NFI 2009 New Freedom Initiative Caregiver Broadcast Survey Form and Instruction
NFI 2009 NFI Survey nfi_satisfaction_survey.2009doc.doc Form and Instruction
nfi_background.doc NFI Background IC Document
nfi_members.doc NFI workgroup members IC Document
NFI_CMS_Accomplishments.pdf NFI CMS accomplishments IC Document

Information Collection (IC) Details

IC Title:	New Freedom Initiative Caregiver Broadcast Survey	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 and Instruction	NFI 2009	NFI Survey	nfi_satisfaction_survey.2009doc.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	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	2,000	0	0	0	0	0
Annual IC Time Burden (Hours)	83	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

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