National ALS Registry Website Satisfaction Survey

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

OMB: 0923-0047

IC ID: 227786

Information Collection (IC) Details

View Information Collection (IC)

National ALS Registry Website Satisfaction Survey 0923-0047-17AYL
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none ALS Customer Satisfaction Survey ALSCustomerSatisfactionSurveyedit088217.pdf Yes Yes Fillable Fileable
Form none ALS Customer Satisfaction Survey - word Attachment A - National ALS Registry Website Satisfaction Survey .docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

2,650 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 2,650 0 2,650 0 0 0
Annual IC Time Burden (Hours) 221 0 221 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Request for Approval 0923-0047- Generic Clrnce Qulitve Fdbck Apprvl Frm- Ntnl ALS Rgstry WebSite .pdf 08/02/2017
Non-research Determination NCEH-ATSDR RDF-ALS wbste stsfctn srvy OSSigned.pdf 08/02/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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