Customer Satisfaction (User Feedback) of a Mobile Application to Improve Preparation and Response to a Terrorist Event or Other Mass Casualty Event

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1009 can be found here:

Documents and Forms

Document Name Document Type
Online Survey.docx Other-WORD
Online Survey - Screenshots.docx Other-WORD
NCIPC Blast Injury Customer Sat Survey Generic Submission Template.docx Other-WORD

Information Collection (IC) Details

IC Title:	Customer Satisfaction (User Feedback) of a Mobile Application to Improve Preparation and Response to a Terrorist Event or Other Mass Casualty Event	Agency IC Tracking Number:	0920-14UO

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD	Online Survey.docx	Yes	Yes	Fillable Printable
Other-WORD	Online Survey - Screenshots.docx	Yes	Yes	Fillable Printable
Other-WORD	NCIPC Blast Injury Customer Sat Survey Generic Submission Template.docx	No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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