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Federal forms, ICRs, and supporting documents

Information Collection

Qualitative Service Delivery Feedback for National Diabetes Education Program (NDEP) through an Online Survey among Health Professionals

IC 212287 under ICR 201112-0925-001 · OMB 0925-0648.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
Information Collection (IC) Details

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Qualitative Service Delivery Feedback for National Diabetes Education Program (NDEP) through an Online Survey among Health Professionals
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Survey Screenshots 1b - Practice Transformation Web satisfaction survey screenshots.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

1,000 0
   
Individuals or Households
 
   100 %

  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 1,000 0 1,000 0 0 0
Annual IC Time Burden (Hours) 167 0 167 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Survey- Word Version 1a - Practice Transformation Web satisfaction survey word version.docx 07/08/2014
Informational Screenshots 1c - Practice Transformation website informational screenshots.pdf 07/08/2014
Fast-track Template Practice Transformation Fast-track template Request for Approval under the Generic Clearance for NDEP Practice Transformation.doc 07/08/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.