Information Collection

Customer Satisfaction Survey for CDC NSMBB Laboratory Accredited to ISO 17043 (Proficiency Testing)

IC 228383 under ICR 201510-0923-001 · OMB 0923-0047.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0923-0047 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Customer Satisfaction Survey for the CDC Newborn Screening Quality Assurance Program Customer Satisfaction Survey for CDC NSMBB Laboratory Accredited to ISO 17043 (Proficiency Testing)	Form and Instruction
Customer Satisfaction Survey for the CDC Newborn Screeni Attachment B1 - Survey_Online.pdf	Form and Instruction
0923-0047 GenIC CDC NSMBB Lab Cust Satisf Srvy_20170913.docx Template - Justification for Customer Satisfaction Survey	IC Document
Attachment A1 - Email Template.pdf Email Invitation to Participate in the Survey	IC Document
Attachment A2 - Hardcopy Solicitation.docx Hardcopy Invitation to Participate in the Su	IC Document
Attachment B2 - Survey_Hardcopy_Word.docx WORD version of Survey Instrument (for reference)	IC Document
Attachment C - Research Determination.pdf CDC Research Determination (no IRB approval required)	IC Document

IC Title:

Customer Satisfaction Survey for CDC NSMBB Laboratory Accredited to ISO 17043 (Proficiency Testing)

Agency IC Tracking Number:

0923-17BCI

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 and Instruction	n/a				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,500

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	3,500	3,500
Annual IC Time Burden (Hours)	583	583
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Template - Justification for Customer Satisfaction Survey		09/19/2017
Email Invitation to Participate in the Survey		09/19/2017
Hardcopy Invitation to Participate in the Su		09/19/2017
WORD version of Survey Instrument (for reference)		09/19/2017
CDC Research Determination (no IRB approval required)		09/19/2017

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

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