Children's Hospital Collaboration Forum Customer Satisfaction Survey

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

OMB: 0920-1026

IC ID: 214764

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Children's Hospital Collaboration Forum Customer Satisfaction Survey 15MF
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Survey Attachment A_Children’s Hospital Collaboration Forum_ Survey.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

90 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 90 0 90 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
Email Invitation Attachment B_Children’s Hospital Collaboration Forum_Invitation Email.docx 01/26/2015
Reminder Email Attachment C_Children’s Hospital Collaboration Forum_Reminder Email.docx 01/26/2015
Request for Approval GenIC 0920-1026_Children's Hospital Collaboration Forum.docx 01/26/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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