Information Collection

Children's Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey

IC 228545 under ICR 201501-0925-004 · OMB 0925-0648.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0648 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Children's Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey	Form and Instruction
1 CHEAR Client Satisfaction Survey CHEAR Client Satisfaction Survey 10.3.2017.docx	Form and Instruction
NIEHS CHEAR Client Satisfaction Survey Fast Track Template 2015.doc Children’s Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey	IC Document

IC Title:

Children's Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	CHEAR Client Satisfaction Survey	CHEAR Client Satisfaction Survey 10.3.2017.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	75	75
Annual IC Time Burden (Hours)	19	19
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Childrenâs Health Exposure Assessment Resource (CHEAR) Client Satisfaction Survey	NIEHS CHEAR Client Satisfaction Survey Fast Track Template 2015.doc	10/03/2017

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