2015 758 CMS OFM Provider Satisfaction Survey

American Customer Satisfaction Index "Customer Satisfaction Surveys"

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0007 can be found here:

Documents and Forms

Document Name Document Type
Form 758 2015 758 CMS OFM Provider Satisfaction Survey Form and Instruction
758 2015 CMS OFM Provider Satisfaction Survey 2015 758 CMS OFM Provider Satisfaction Survey.docx Form and Instruction

Information Collection (IC) Details

IC Title:	2015 758 CMS OFM Provider Satisfaction Survey	Agency IC Tracking Number:	758

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	758	2015 CMS OFM Provider Satisfaction Survey	2015 758 CMS OFM Provider Satisfaction Survey.docx		No		Printable Only

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	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	250	250
Annual IC Time Burden (Hours)	42	42
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.