Semi-structured telephone interview for end users who are stakeholders in PROMIS

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (OD/OER)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Semi-structured telephone interview for end users who are stakeholders in PROMIS Form and Instruction
1 Survey PROMIS Semi-structured Interview Questions FINAL.docx Form and Instruction
KAI for PROMIS Survey OMB Form_FINAL (2).DOCX KAI for PROMIS Survey OMB Form_FINAL (2) IC Document

Information Collection (IC) Details

IC Title:	Semi-structured telephone interview for end users who are stakeholders in PROMIS	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	1	Survey	PROMIS Semi-structured Interview Questions FINAL.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	15	0	0	0	0	0
Annual IC Time Burden (Hours)	10	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
KAI for PROMIS Survey OMB Form_FINAL (2)	KAI for PROMIS Survey OMB Form_FINAL (2).DOCX	05/30/2012

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