Web based Customer Satisfaction form for collecting feedback on NIH/NIAID/DAIDS Clinical Quality Assurance Process

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0668 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Web based Customer Satisfaction form for collecting feedback on NIH/NIAID/DAIDS Clinical Quality Assurance Process Form and Instruction
1 Attachment 1 DAIDS cQMP Attachment 1 DAIDS cQMP Fillable PDF final w burden statement (1).pdf Form and Instruction
DAIDS cQMP customer feedback 02 23 2016 rev.doc Fast Track for DAIDS Clinical Quality Assurance Process IC Document

Information Collection (IC) Details

IC Title:	Web based Customer Satisfaction form for collecting feedback on NIH/NIAID/DAIDS Clinical Quality Assurance Process	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	1	Attachment 1 DAIDS cQMP	Attachment 1 DAIDS cQMP Fillable PDF final w burden statement (1).pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 160	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	320	320
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track for DAIDS Clinical Quality Assurance Process	DAIDS cQMP customer feedback 02 23 2016 rev.doc	02/24/2016

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