The World Trade Center Health Program Customer Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIOSH 2)

OMB: 0920-0953

IC ID: 212365

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

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The World Trade Center Health Program Customer Satisfaction Survey 0920-095314AOR
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0953 WTC Customer Satisfaction Survey WTC Customer Satisfaction Survey.doc Yes Yes Fillable Fileable
Form and Instruction 0920-0953 WTC screen shots WTC screen shots.pdf Yes Yes Fillable Fileable

Health Health Care Services

Federal Register Citation  79 FR 24432

6,500 0
   
Individuals or Households
 
   10 %

  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 6,500 0 6,500 0 0 0
Annual IC Time Burden (Hours) 1,083 0 1,083 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
English version English version.docx 07/16/2014
Spanish version Spanish version.docx 07/16/2014
Polish version Polish version.doc 07/16/2014
Chinese version Chinese version.doc 07/16/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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