Donation Experience Survey

Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

OMB: 0915-0212

IC ID: 241938

Information Collection (IC) Details

View Information Collection (IC)

Donation Experience Survey
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 New Survey - Be The Match Donation Experience Generic.docx FORM - New Survey - Be The Match Donation Experience Generic.docx Yes Yes Fillable Fileable
Form and Instruction 1 R Old Survey Redline - Be The Match Donation Experience Generic.docx FORM Old Survey Redline - Be The Match Donation Experience Generic.docx Yes Yes Fillable Fileable

Health Health Care Services

 

1,625 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,625 0 1,625 0 0 0
Annual IC Time Burden (Hours) 218 0 218 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Updated SS A CLEAN 6-17-20 06.17.2020 - Sup Statement - BeTheMatch Donation Experience CLEAN.docx 06/17/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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