Information Collection

Customer Satisfaction Surveys for the Health Literacy Training Program

IC 217329 under ICR 201502-0915-002 · OMB 0915-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Customer Satisfaction Surveys for the Health Literacy Training Program	Form
1 Health Literacy Training for Health Professionals Custom CustomerSatisfactionSurvey_HPTraining_final.doc	Form
2 Health Literacy Training of Trainers Customer Satisfacti CustomerSatisfactionSurvey_ToT_final.doc	Form
GENERIC Customer Satisfaction - Supporting Statement_JSIV2.docx Health Literacy Project\GENERIC Customer Satisfaction - Supporting Statement_JSIV2	IC Document

IC Title:

Customer Satisfaction Surveys for the Health Literacy Training Program

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	1	Health Literacy Training for Health Professionals Customer Satisfaction Survey	CustomerSatisfactionSurvey_HPTraining_final.doc		No		Paper Only
Form	2	Health Literacy Training of Trainers Customer Satisfaction Survey	CustomerSatisfactionSurvey_ToT_final.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 4 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,600	2,600
Annual IC Time Burden (Hours)	225	225
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Health Literacy Project\GENERIC Customer Satisfaction - Supporting Statement_JSIV2	GENERIC Customer Satisfaction - Supporting Statement_JSIV2.docx	07/06/2015

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