OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Pretest Survey

IC 202022 under ICR 201204-0990-002 · OMB 0990-0398.

Documents and Forms
Document Name
Document Type
Other-survey
Other-Consumer Privacy Survey
Other-Consumer Privacy Survey
Other-Consumer Privacy Survey Spanis
Other-Questionnaire
Other-Slides
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Pretest Survey
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Consumer Privacy Survey ONCConsumerPrivacySurveyFinal05-02-2012.docx Yes Yes Printable Only
Other-Questionnaire 0990-ONCConsumerPrivacySurvey Questionnaire Final6 19.docx Yes Yes Printable Only
Other-Slides 0990-ONCcunsumerBriefing Slides Cognitive Interviews_022912.pptx Yes Yes Printable Only
Other-survey 0990- ONC-ConsumerSurvey.docx Yes Yes Printable Only
Other-Consumer Privacy Survey Spanish ONCConsumerPrivacySurveyFinalSpanish.docx Yes Yes Printable Only
Other-Consumer Privacy Survey HHS ONC ConsumerPrivacySurveyFinal5.2.docx Yes Yes Printable Only

Health Illness Prevention

 

33 0
   
Individuals or Households
 
   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 33 0 33 0 0 0
Annual IC Time Burden (Hours) 8 0 8 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
ONCConsumerPrivacySurveyIntroScript ONCConsumerPrivacySurveyIntroScript.docx 05/15/2012
ONCConsumerPrivacySurveyIntroScriptSpanish ONCConsumerPrivacySurveyIntroScriptSpanish.docx 05/15/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.