CIS LiveHelp Questionnaire

Collection of Customer Service, Demographic and Smoking/Tobacco Use Information from NCI Cancer Information Service (CIS) Clients

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0208 can be found here:

Documents and Forms

Document Name Document Type
Form 3 CIS LiveHelp Questionnaire Form
3 LiveHelp Questionnaire Appendix 2 B LiveHelp Customer Service Demographic Qs.doc www.cancer.gov Form

Information Collection (IC) Details

IC Title:	CIS LiveHelp Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		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	3	LiveHelp Questionnaire	Appendix 2 B LiveHelp Customer Service Demographic Qs.doc	www.cancer.gov	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 7,014	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	7,014	7,014
Annual IC Time Burden (Hours)	234	234
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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