Information Collection

OAMP Customer Satisfaction Survey

IC 240443 under ICR 201506-0915-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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 OAMP Customer Satisfaction Survey	Form
1 Example Survey in Survey Monkey - OAMP.pdf Example Survey in Survey Monkey - OAMP.pdf	Form
HRSA-OAMP Customer Satisfaction Survey Supporting Statement 6-23-20 EDITED.docx SS A	IC Document

IC Title:

OAMP 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	1	Example Survey in Survey Monkey - OAMP.pdf	Example Survey in Survey Monkey - OAMP.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 197

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	985	985
Annual IC Time Burden (Hours)	246	246
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SS A	HRSA-OAMP Customer Satisfaction Survey Supporting Statement 6-23-20 EDITED.docx	07/01/2020

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