Information Collection

Survey for Obtaining Feedback on HIPAA Training for State Attorneys General & Staff and HIPAA and Security Peformance Audit Survey for Selected Covered Entities

IC 202021 under ICR 201208-0955-003 · OMB 0955-0003.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0955-0003 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-0383_OCRAudi&SAGt - Entity Survey v04.13.12.docx	Other-survey
0990-0383_SAG Customer Satisfaction Survey In Person (2).docx	Other-survey
0990-0383-SAG Customer Satisfaction Survey In Person (2).docx	Other-survey
0990-0383 - Audit & SAG v04.13.12.docx 0990-0383 - Audit & SAG v04	IC Document
0990-0383_Survey Cover Letter to In-Person Participants.docx 0990-0383_Survey Cover Letter to In-Person Participants	IC Document
0990-0383Survey Cover Letter to CBT Participants (2).docx 0990-0383Survey Cover Letter to CBT Participants (2)	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Survey for Obtaining Feedback on HIPAA Training for State Attorneys General & Staff and HIPAA and Security Peformance Audit Survey for Selected Covered Entities

Agency IC Tracking Number:

IC Status: Removed

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey	0990-0383_OCRAudi&SAGt - Entity Survey v04.13.12.docx	Yes	Yes	Fillable Printable
Other-survey	0990-0383_SAG Customer Satisfaction Survey In Person (2).docx	Yes	No	Printable Only
Other-survey	0990-0383-SAG Customer Satisfaction Survey In Person (2).docx	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 555

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	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	555	0	0	0	0	0
Annual IC Time Burden (Hours)	46	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
0990-0383 - Audit & SAG v04	0990-0383 - Audit & SAG v04.13.12.docx	04/20/2012
0990-0383_Survey Cover Letter to In-Person Participants	0990-0383_Survey Cover Letter to In-Person Participants.docx	04/20/2012
0990-0383Survey Cover Letter to CBT Participants (2)	0990-0383Survey Cover Letter to CBT Participants (2).docx	04/20/2012

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