(CMS-10585) QualityNet.org and QualityNet Secure Portal Customer Satisfaction and Task Prioritization Survey for Phase 1 of the QualityNet Portal (QNP) redesign project

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1185 can be found here:

Documents and Forms

Document Name Document Type
Form CMS-10585 (CMS-10585) QualityNet.org and QualityNet Secure Portal Customer Satisfaction and Task Prioritization Survey for Phase 1 of the QualityNet Portal (QNP) redesign project Form and Instruction
CMS-10585 Quality Net User Survey QualityNet_User_Survey_090315.docx Form and Instruction
CMS-10585 Generic Clearance Submission Template-QualityNetPortal_UserSurvey.docx CMS-10585 QualityNet Secure Portal Customer Satisfaction and Task Prioritization IC Document

Information Collection (IC) Details

IC Title:	(CMS-10585) QualityNet.org and QualityNet Secure Portal Customer Satisfaction and Task Prioritization Survey for Phase 1 of the QualityNet Portal (QNP) redesign project	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10585	Quality Net User Survey	QualityNet_User_Survey_090315.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 60

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CMS-10585 QualityNet Secure Portal Customer Satisfaction and Task Prioritization	CMS-10585 Generic Clearance Submission Template-QualityNetPortal_UserSurvey.docx	09/24/2015

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