Information Collection

Office of Public Health Online Customer Satisfaction Survey

IC 219348 under ICR 201503-1090-001 · OMB 1090-0011.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1090-0011 can be found here:

Documents and Forms

Document Name Document Type
NPS Office of Public Health Survey.pdf Other-Survey Instrument
1090-0011 NPS OPH survey Justification.docx Fast Track Justification IC Document
Sample Email to Customer.pdf Sample Introductory Letters IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Office of Public Health Online Customer Satisfaction Survey	Agency IC Tracking Number:	FT30

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey Instrument			NPS Office of Public Health Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	Number of Respondents for Small Entity: 50

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Justification	1090-0011 NPS OPH survey Justification.docx	12/18/2015
Sample Introductory Letters	Sample Email to Customer.pdf	12/18/2015

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