Stakeholder Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Program

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

OMB: 0935-0179

IC ID: 223278

Information Collection (IC) Details

View Information Collection (IC)

Stakeholder Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Program
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Questions for Stakeholders Customer Satisfaction Survey_stakeholder FINAL.docx Yes Yes Fillable Fileable

Health Health Care Services

 

400 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 400 0 400 0 0 0
Annual IC Time Burden (Hours) 100 0 100 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Part A Generic Clearance Submission_Stakeholders FINAL review.doc 08/31/2016
Cover Letter OMB Cover Letter.doc 08/31/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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