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GenIC #44 - Oral Health Initiative, Customer Satisfaction Survey Tool

IC 218238 under ICR 201410-0938-016 · OMB 0938-1148.

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Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
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GenIC #44 - Oral Health Initiative, Customer Satisfaction Survey Tool
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10398 (#44) Customer Satisfaction Evaluation of Form CMS-416 Web-Based Training Modules 44 - CMS-416 Curriculum Evaluation [rev 09-17-2015 by OSORA PRA] -- CLEAN.docx Yes Yes Fillable Printable

Health Health Care Services

 

56 0
   
State, Local, and Tribal Governments
 
   0 %

  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 56 0 56 0 0 0
Annual IC Time Burden (Hours) 14 0 14 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement 44 - Supporting Statement Oral Health Initiative Tool [rev 09-17-2015 by OSORA PRA] -- CLEAN.docx 09/18/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.