Information Collection

IHS Web Services Customer Satisfaction Survey

IC 223611 under ICR 201504-0917-007 · OMB 0917-0036.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0036 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form IHS Web Services C IHS Web Services Customer Satisfaction Survey	Form
IHS Web Services C IHS Web Services Customer Feedback IndianHealthService_WebServicesCustomerFeedback.docx	Form
2014 Generic Clearance Submission Template - IHS Web Services Customer Satisfaction Survey Aug2016.doc IHS Web Service Customer Satisfaction Survey	IC Document

IC Title:

IHS Web Services Customer 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	IHS Web Services Customer Feedback	IHS Web Services Customer Feedback	IndianHealthService_WebServicesCustomerFeedback.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

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	600	600
Annual IC Time Burden (Hours)	49	49
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
IHS Web Service Customer Satisfaction Survey	2014 Generic Clearance Submission Template - IHS Web Services Customer Satisfaction Survey Aug2016.doc	10/25/2016

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