Information Collection

Genetic and Rare Diseases Information Center Customer Satisfaction Survey

IC 210515 under ICR 201112-0925-001 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Survey Screenshots Genetic and Rare Diseases Information Center Customer Satisfaction Survey	Form and Instruction
Form 2 Script Genetic and Rare Diseases Information Center Customer Satisfaction Survey	Form
1 Survey Screenshots Attachment E - English Survey Screenshots.docx	Form and Instruction
2 Script Attachment A - GARD English Scripts.docx	Form
Fast-Track Form_GARD_120313_FINAL.doc Fast-Track Form_GARD_120313_FINAL	IC Document
Attachment B - GARD Spanish Scripts.docx Attachment B - GARD Spanish Scripts	IC Document
Attachment C - English Survey.docx Attachment C - English Survey	IC Document
Attachment D - Spanish Survey.docx Attachment D - Spanish Survey	IC Document
Attachment F - Spanish Survey Screenshots.docx Attachment F - Spanish Survey Screenshots	IC Document

IC Title:

Genetic and Rare Diseases Information Center Customer Satisfaction Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1				No	No	Fillable Fileable
Form	2				No	No	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 576

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	576	0	0	0	0	0
Annual IC Time Burden (Hours)	96	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast-Track Form_GARD_120313_FINAL		02/24/2014
Attachment B - GARD Spanish Scripts		02/24/2014
Attachment C - English Survey		02/24/2014
Attachment D - Spanish Survey		02/24/2014
Attachment F - Spanish Survey Screenshots		02/24/2014

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

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