Information Collection

GenIC#11 - CMS Consumer Research on Websites and Tools

IC 226386 under ICR 201307-0938-017 · OMB 0938-1247.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1247 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10437 GenIC#11 - CMS Consumer Research on Websites and Tools	Form and Instruction
CMS-10437 GenIC#11 - CMS Consumer Research on Websites and Tools CMS-10437.GenIC#11.WebToolsResearch_Instrument_FINAL.docx	Form and Instruction
CMS-10437.GenIC#11.WebToolsResearch_SupportingStatement_FINAL.docx CMS-10437.GenIC#11.WebToolsResearch_SupportingStatement_FINAL	IC Document
CMS-10437.GenIC#11 - Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research.docx CMS-10437.GenIC#11 - Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Researc	IC Document

IC Title:

GenIC#11 - CMS Consumer Research on Websites and Tools

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	CMS-10437	GenIC#11 - CMS Consumer Research on Websites and Tools	CMS-10437.GenIC#11.WebToolsResearch_Instrument_FINAL.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CMS-10437.GenIC#11.WebToolsResearch_SupportingStatement_FINAL	CMS-10437.GenIC#11.WebToolsResearch_SupportingStatement_FINAL.docx	04/13/2017
CMS-10437.GenIC#11 - Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research	CMS-10437.GenIC#11 - Justification for Providing Incentives for Participation in Marketing Research_Consumer Qualitative Research.docx	04/13/2017

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